Open AccessEuglycaemic DKA secondary to Canaglifozin, an easily missed diagnosis
Author(s) -
Raj Kumar Bhatnagar,
Isuri Kurera,
Robert H. Perry,
Jennifer Tringham
Publication year - 2017
Publication title -
acute medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.14
H-Index - 12
eISSN - 1747-4892
pISSN - 1747-4884
DOI - 10.52964/amja.0683
Subject(s) - ketonuria , medicine , diabetic ketoacidosis , metabolic acidosis , ketosis , metabolic control analysis , acidosis , diabetes mellitus , pediatrics , canagliflozin , ketoacidosis , metabolic disorder , intensive care medicine , endocrinology , type 1 diabetes , type 2 diabetes
Diabetic ketoacidosis (DKA) is a state of hyperglycaemia, ketosis and metabolic acidosis. This carries a significant morbidity and mortality particularly if left untreated or if the diagnosis is delayed. We present a case of euglycaemic DKA in a 48 year old female with non-insulin treated T2DM who had good glycaemic control. Initial investigations revealed moderate metabolic acidosis, persistent ketonuria and blood glucose levels < 11mmol/l. There was a significant delay in diagnosing DKA following admission with multiple consultant reviews. Detailed history revealed the recent addition of Canagliflozin (SGLT2 inhibitor). This can rarely be a precipitant of euglycaemic DKA. With appropriate DKA treatment, rapid correction of acidaemia and ketosis occurred allowing her to be discharged home within 24 hours.