Euglycemic diabetic ketoacidosis - a rare side effect of sodium-glucose co-transporter-2 inhibitor in a patient of type 2 diabetes mellitus with left ventricular dysfunction: a case report
Keywords:Type 2 diabetes mellitus, Diabetic ketoacidosis, SGLT-2
A 42 year old female with type 2 diabetes mellitus (T2DM), presented with angina on exertion and left ventricular (LV) dysfunction (global LV ejection fraction (EF)=26%). Patient was subjected to coronary angiography which revealed triple vessel disease. Patient was started on usual standard of care heart failure (HF) medications, including sodium-glucose co-transporter-2 (SGLT-2) inhibitor dapagliflozin which is promising new class of drug for treating T2DM and HF. Patient was advised myocardial revascularization in form of percutaneous transluminal coronary angioplasty (PTCA). Post angioplasty patient developed metabolic acidosis (high anion gap with normal lactate and increased ketone levels). Patient was diagnosed as case of euglycemic diabetic ketoacidosis (DKA) and patient was treated by volume resuscitation and insulin infusion.
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