PT  - JOURNAL ARTICLE
AU  - Duncan Taylor Ritchie
AU  - James Dixon
TI  - SGLT-2 inhibitor associated euglycaemic diabetic ketoacidosis in an orthopaedic trauma patient
AID  - 10.1136/bcr-2022-250233
DP  - 2022 Sep 01
TA  - BMJ Case Reports
PG  - e250233
VI  - 15
IP  - 9
4099  - http://casereports.bmj.com/content/15/9/e250233.short
4100  - http://casereports.bmj.com/content/15/9/e250233.full
SO  - BMJ Case Reports2022 Sep 01; 15
AB  - Euglycaemic diabetic ketoacidosis is a serious but rare adverse effect of treatment with sodium-glucose cotransporter-2 (SGLT-2) inhibitors. A man in his 60s with type 2 diabetes mellitus underwent total hip replacement for an intracapsular neck of femur fracture. His SGLT-2 inhibitor was continued perioperatively and blood glucose levels were normal throughout the admission. A diagnosis of severe euglycaemic diabetic ketoacidosis was made in the operating theatre which required treatment in a critical care unit. This resulted in increased morbidity due to decreased postoperative mobilisation and a new requirement for subcutaneous insulin. This case highlights the need for withholding SGLT-2 inhibitors in patients admitted for emergency surgery and a need for regular ketone monitoring in these patients, even in the context of normoglycaemia.