Early detection of euglycemic ketoacidosis during thoracic surgery associated with empagliflozin in a patient with type 2 diabetes: A case report

We report the first case of intraoperatively detected euglycemic diabetic ketoacidosis (DKA) associated with sodium –glucose cotransporter 2 inhibitors (SGLT2is). A 59‐year‐old man had a 12‐year history of type 2 diabetes mellitus treated with insulin and empagliflozin. He developed bacterial empyema and was initiated with antibiotics at a local hospital. Owning to the persistence of his symptoms, he was transferred to our hospital after the medication of empagliflozin the day before surgery. After overnight fasting, he underwent thoracoscopic debridement and intrathoracic lavage surgery. During this surgery, he was noted euglycemic ketosis and acidosis and diagnosed as euglycemic DKA. Immediately a fter the consultation to our department, he underwent the treatment for DKA. He awoke from anesthesia normally and showed no symptoms of DKA. DKA gradually resolved over the next 24 hours. Early identification and management are critical for rapid recovery from perioperative euglycemic DKA associate d with SGLT2is, especially during thoracic surgery.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: CASE REPORT Source Type: research