Sodium-Glucose Co-transporter 2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis in a Patient with Type 2 Diabetes Mellitus: A Case Report

I-Hsuan Huang ； Chien-Hsing Lee ； Jia-lun Huang ； Yi-Jen Hung

《Formosan Journal of Endocrinology and Metabolism》 8卷1期 (2017/06) Pp. 24-27

https://doi.org/10.6856/FJEM.201706_8(1).0004

摘要

Background. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of anti-diabetic medications which decrease renal glucose reabsorption and reduce blood glucose level for the treatment of type 2 diabetes. SGLT2 inhibitors are occasionally reported to be associated with euglycemic diabetic ketoacidosis (euDKA). Methods. We report a case with type 2 diabetes developed SGLT2 inhibitor-associated euDKA in Taiwan. Results. A 27-year-old woman had type 2 diabetes for 9 years and was recently treated with multiple daily insulin injection (insulin glargine 48 units once daily and insulin aspart 22 units thrice daily). Her HbA1c was 10.1%. Empagliflozin (10 mg/day) was prescribed for glycemic control 2 days ago. She presented to emergency room with nausea and vomiting. Laboratory analyses revealed serum glucose was 214 mg/dL, β-hydroxybutyrate concentration was increased, and metabolic acidosis. These data indicated she had euDKA. Empagliflozin was discontinued and she was treated successfully with intravenous insulin and fluids. Conclusion. EuDKA should be considered in patients with type 2 diabetes who experience nausea and vomiting, and are being treated with SGLT2 inhibitors.

關鍵字

sodium-glucose co-transporter 2 ； ketoacidosis ； diabetes mellitus