Empagliflozin
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Euglycaemic diabetic ketoacidosis: case report A 61‑year‑old man developed euglycemic diabetic ketoacidosis during treatment with empagliflozin for type 2 diabetes mellitus. The man presented to the emergency room with increased glycosylated haemoglobin. He had been receiving Mixtard 70/30, which is a form of insulin, metformin/sitagliptin and empagliflozin 10mg daily [route not stated]. The dosage of empagliflozin was increased to 25mg daily five days prior to the current presentation. On presentation, he reported diffuse abdominal pain, nausea, vomiting and decreased oral intake. He was haemodynamically stable and afebrile. Physical examination was unremarkable except for mild abdominal tenderness. Laboratory investigation showed a pH of 7.21, elevated serum glucose, lactate and high anion gap while decreased serum bicarbonate and partial pressure of carbon dioxide. Urinalysis revealed presence of 4+ ketone bodies. His complete blood count, serum electrolytes, amylase, creatinine, blood urea nitrogen, lipase and liver function tests were within reference range. The cardiac findings and septic workup was negative. He was admitted with a diagnosis of empagliflozin-induced euglycaemic diabetic ketoacidosis [duration of treatment to reaction onset not stated]. The man was treated with insulin infusion and continuous IV hydration. His acidosis resolved with normalisation of anion gap within the 24h of presentation. Insulin infusion and IV fluids were stopped on day 3. He was discharged on gliclazide, extended release metformin and Mixtard 70/30. Albugami M, et al. Empagliflozin-induced euglycemic diabetic ketoacidosis in type 2 diabetes mellitus. Saudi Journal of Medicine and Medical Sciences 8: 241-242, No. 3, 803517251 Sep-Dec 2020. Available from: URL: http://doi.org/10.4103/sjmms.sjmms_325_20
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Reactions 28 Nov 2020 No. 1832
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