Euglycemic diabetic ketoacidosis induced by empagliflozin in the setting of helicobacter pylori and hypertriglyceridemia treatment

Abstract

Euglycemic diabetic ketoacidosis (EDKA) is a rare complication in diabetes, with clinical triad: 1) metabolic acidosis with an increased anion gap, 2) ketonemia or/and ketonuria, and 3) normal levels of glucose in the blood (<11 mmol/L). This condition is very challenging to diagnose as euglycemia can mask the underlying diabetic acute complication of ketoacidosis. Therefore, clinical suspicion is needed in all patients at possible risk for EDKA. Here, we present a patient with type 2 diabetes, obesity, and hypertriglyceridemia. Also, with a history of cardiovascular disease, He was diagnosed with EDKA on admission and treated recently with Empagliflozin in a setting of Helicobacter pylori Eradication Therapy and Bezafibrate for hypertriglyceridemia. During admission, the patient was treated with fluids intravenously and insulin according to glucose levels in the blood until the metabolic acidosis was reversed.