Euglycemic Diabetic Ketoacidosis in Concurrent Very Low-carbohydrate Diet and Sodium-glucose Transporter-2 Inhibitor Use: A Case Report
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Introduction: With the incredibly high incidence of Type 2 Diabetes in the current population of emergency department patients, it is critical for clinicians to understand the possible complications of the treatment of this disease. Medication like canagliflozin are more common to encounter on patient’s home medication lists and clinicians should be aware of how these medications, alone or combined with dietary modifications, can result in significant pathology and even mortality if not appropriately treated. Case Report: We report a case of a patient with type II diabetes mellitus who presented with euglycemic diabetic ketoacidosis in the setting of concurrent use of canagliflozin, a sodium-glucose transporter-2 (SGLT-2) inhibitor, and strict adherence to a low-carbohydrate ketogenic diet for weight control. Discussion: Euglycemic ketoacidosis has previously been observed in both diabetic and non-diabetic patients following strict ketogenic diets, as well as in diabetic patients being treated with SGLT-2 inhibitors. Conclusion: As more patients choose ketogenic diets for weight control and diabetes management, clinicians should be aware of this potentially life-threatening complication in patients concurrently taking SGLT-2 inhibitors.
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To date, few cases have been reported of euDKA associated with SGLT2 inhibitor use and ketogenic diets in patients with T2DM.
“To date, few cases have been reported of euDKA associated with SGLT2 inhibitor use and ketogenic diets in patients with T2DM.”
From Euglycemic Diabetic Ketoacidosis Caused by SGLT2 Inhibitors and a Ketogenic Diet: A Case Series and Review of Literature (2021) · cites this paper as [18]
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Ketoacidosis during a Low-Carbohydrate Diet
Shah, P., & Isley, W. L. (2006) · New England Journal of Medicine · doi:10.1056/nejmc052709 · Cited by 95 · see citing works
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SGLT-2 inhibitors associated euglycemic and hyperglycemic DKA in a multicentric cohort
Ata, F., Yousaf, Z., Khan, A. A., Razok, A., Akram, J., Ali, E. A. H., Abdalhadi, A., Ibrahim, D. A., Al Mohanadi, D. H. S. H., & Danjuma, M. I. (2021) · Scientific Reports · doi:10.1038/s41598-021-89752-w · Cited by 87 · see citing works
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Very low carbohydrate diet and SGLT-2-inhibitor: double jeopardy in relation to ketoacidosis
Tougaard, N. H., Faber, J., & Eldrup, E. (2019) · BMJ Case Reports · doi:10.1136/bcr-2018-227516 · Cited by 16 · see citing works
- Authors
- Earle, M., Ault, B., & Bonney, C.
- Affiliations
- University of Nevada, Las Vegas (US)
- Corresponding author
- Earle, Matthew
- Venue
- Clinical Practice and Cases in Emergency Medicine
- Publisher
- California Digital Library (CDL)
- Published
- 2020-04-23
- Volume
- 4
- Issue
- 2
- Pages
- 185-188
- ISSN
- 2474-252X (ISSN-L)
- PMC
- PMC7219989
- OpenAlex
- W3023943604
- Cited by
- 14
- References
- 3
- Citations by year
- 2023: 2 · 2022: 7 · 2021: 3 · 2020: 1 · 2019: 1
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Clinical Practice and Cases in Emergency Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- euglycemic diabetic ketoacidosis, type 2 diabetes, canagliflozin, SGLT2 inhibitors, weight management, food-drug interactions, adverse drug reactions, emergency department
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