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We herein present the case of a 21-year-old diabetic obese woman who developed ketoacidosis following the administration of ipragliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. At the time of admission, although her serum glucose level was only 175 mg/dL, laboratory tests showed ketoacidosis. Interestingly, hyperglycosuria persisted, even after the discontinuation of ipragliflozin. This is the first report of non-hyperglycemic ketoacidosis that might have been caused by protracted hyperglycosuria after the discontinuation of ipragliflozin. The development of non-hyperglycemic ketoacidosis should be monitored following the discontinuation of SGLT2 inhibitors, especially in patients who start to feel unwell and exhibit protracted hyperglycosuria after the discontinuation of treatment.

Atypical Ketoacidosis and Protracted Hyperglycosuria after Treatment with Ipragliflozin, an SGLT2 Inhibitor