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Euglycaemic diabetic ketoacidosis in bariatric surgery patients with type 2 diabetes taking canagliflozin
  1. Christoffel van Niekerk,
  2. James Wallace,
  3. Mark Takata,
  4. Roger Yu
  1. Department of Internal Medicine, Scripps Clinic - Scripps Green Hospital, La Jolla, California, USA
  1. Correspondence to Dr Christoffel van Niekerk, vanniekerk.christoffel{at}


A 52-year-old type 2 diabetic man previously on canagliflozin developed severe anion gap metabolic acidosis and markedly elevated beta-hydroxybutyrate on postoperative day (POD) 2 status post laparoscopic Roux-en-Y gastric bypass. An insulin drip and aggressive intravenous fluid repletion were initiated, and electrolytes were monitored and repleted. His anion gap closed, and he was discharged on POD 4. This euglycaemic diabetic ketoacidosis prolonged his hospital stay by 2 days.

  • drugs and medicines
  • endocrine system
  • drug therapy related to surgery
  • diabetes
  • gastrointestinal surgery
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  • Contributors CvN was instrumental in the planning, formatting and writing of this manuscript. JW played a major role in writing, editing and acquisition of data. MT and RY played major roles in acquisition of data, conception and design of the case report, and editing of the final manuscript. All authors met the four ICMJE criteria for authorship. All authors gave final approval for submission of this article.

  • Funding The authors had no public, commercial or not-for-profit funding for this paper.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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