Frontiers in Endocrinology (May 2022)

Case Report: High-Calorie Glucose Infusion and Tight Glycemic Control in Ameliorating Refractory Acidosis of Empagliflozin-Induced Euglycemic Diabetic Ketoacidosis

  • Siti Sanaa Wan Azman,
  • Norlela Sukor,
  • Muhammad Yusuf Abu Shamsi,
  • Ilham Ismail,
  • Nor Azmi Kamaruddin

DOI
https://doi.org/10.3389/fendo.2022.867647
Journal volume & issue
Vol. 13

Abstract

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The current widespread use of sodium-glucose co-transporter 2 (SGLT2) inhibitors has triggered an increase in reported cases of euglycemic diabetic ketoacidosis (EDKA), often characterized by a protracted metabolic acidosis that is resistant to conventional DKA treatment. We report a case of empagliflozin-induced EDKA with severe metabolic acidosis intractable to aggressive fluid resuscitation and boluses of bicarbonate infusion. Following the introduction of high-calorie glucose infusion coupled with tight glycemic control, the recalcitrant acidosis was successfully corrected. This is the first case report that adopts the above approach, representing a paradigm shift in the management of SGLT2 inhibitor-induced EDKA.

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