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Euglycaemic diabetic ketoacidosis — RCPSC IM MCQ

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HardEndocrinologyEuglycaemic diabetic ketoacidosisRCPSC IM

A 33-year-old woman on an SGLT2 inhibitor for type 2 diabetes presents with nausea, abdominal pain, and tachypnoea after a low-carbohydrate diet and reduced insulin. Glucose is 9.8 mmol/L, pH is 7.19, bicarbonate is 11 mmol/L, and beta-hydroxybutyrate is high. What is the most likely cause?

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Correct answer: D — SGLT2 inhibitor-associated euglycaemic ketoacidosis

SGLT2 inhibitors can precipitate euglycaemic ketoacidosis, particularly with reduced insulin, low carbohydrate intake, dehydration, or acute illness.

Reference: Diabetes Canada clinical practice guidelines