TY - JOUR T1 - SGLT-2 inhibitor associated euglycaemic diabetic ketoacidosis in an orthopaedic trauma patient JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2022-250233 VL - 15 IS - 9 SP - e250233 AU - Duncan Taylor Ritchie AU - James Dixon Y1 - 2022/09/01 UR - http://casereports.bmj.com/content/15/9/e250233.abstract N2 - 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. ER -