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Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin
Euglycemic diabetic ketoacidosis (EDKA) is an uncommon diabetic complication with increasing prevalence and is associated with the use of sodium-glucose co-transporter 2 inhibitors (SGLT2i). We report the case of a 77-year-old female patient with type 2 diabetes mellitus, treated with metformin/lina...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885381/ https://www.ncbi.nlm.nih.gov/pubmed/36726923 http://dx.doi.org/10.7759/cureus.33161 |
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author | Fustiga, João Fernandes, Marco Dâmaso, Francisca Duarte, Joana A Rodrigues, Catarina |
author_facet | Fustiga, João Fernandes, Marco Dâmaso, Francisca Duarte, Joana A Rodrigues, Catarina |
author_sort | Fustiga, João |
collection | PubMed |
description | Euglycemic diabetic ketoacidosis (EDKA) is an uncommon diabetic complication with increasing prevalence and is associated with the use of sodium-glucose co-transporter 2 inhibitors (SGLT2i). We report the case of a 77-year-old female patient with type 2 diabetes mellitus, treated with metformin/linagliptin and empagliflozin, who initiated a slurred speech and altered level of consciousness in the postoperative period of a cholecystectomy. On observation, the patient presented with Kussmaul breathing and mucosal dryness and was ketotic. Laboratory exams showed metabolic acidosis with an elevated anion gap, normoglycemia, and positive ketonemia. Fluid replacement with dextrose solution and continuous insulin infusion were initiated, with progressive clinical and laboratory improvement. On discharge, she showed resolution of symptoms, and empagliflozin was discontinued from her usual medication. Despite the warnings of European and American medical agencies in 2015/2016, EDKA remains a challenging diagnosis due to its unspecific and insidious symptoms. |
format | Online Article Text |
id | pubmed-9885381 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-98853812023-01-31 Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin Fustiga, João Fernandes, Marco Dâmaso, Francisca Duarte, Joana A Rodrigues, Catarina Cureus Emergency Medicine Euglycemic diabetic ketoacidosis (EDKA) is an uncommon diabetic complication with increasing prevalence and is associated with the use of sodium-glucose co-transporter 2 inhibitors (SGLT2i). We report the case of a 77-year-old female patient with type 2 diabetes mellitus, treated with metformin/linagliptin and empagliflozin, who initiated a slurred speech and altered level of consciousness in the postoperative period of a cholecystectomy. On observation, the patient presented with Kussmaul breathing and mucosal dryness and was ketotic. Laboratory exams showed metabolic acidosis with an elevated anion gap, normoglycemia, and positive ketonemia. Fluid replacement with dextrose solution and continuous insulin infusion were initiated, with progressive clinical and laboratory improvement. On discharge, she showed resolution of symptoms, and empagliflozin was discontinued from her usual medication. Despite the warnings of European and American medical agencies in 2015/2016, EDKA remains a challenging diagnosis due to its unspecific and insidious symptoms. Cureus 2022-12-31 /pmc/articles/PMC9885381/ /pubmed/36726923 http://dx.doi.org/10.7759/cureus.33161 Text en Copyright © 2022, Fustiga et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Fustiga, João Fernandes, Marco Dâmaso, Francisca Duarte, Joana A Rodrigues, Catarina Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title | Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title_full | Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title_fullStr | Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title_full_unstemmed | Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title_short | Postop Complication With Euglycemic Diabetic Ketoacidosis in a Patient Receiving Empagliflozin |
title_sort | postop complication with euglycemic diabetic ketoacidosis in a patient receiving empagliflozin |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885381/ https://www.ncbi.nlm.nih.gov/pubmed/36726923 http://dx.doi.org/10.7759/cureus.33161 |
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