Clinical Report: Rapid Development of Euglycemic Diabetic Ketoacidosis After Initiation of Henagliflozin
Overview
This case study describes a 40-year-old woman who developed severe euglycemic diabetic ketoacidosis (euDKA) within 4 days of initiating henagliflozin, an SGLT2 inhibitor, alongside metformin. The euDKA was precipitated by gastrointestinal adverse effects from metformin, leading to reduced oral intake and dehydration.
Background
Euglycemic diabetic ketoacidosis (euDKA) is a serious metabolic complication that can occur with SGLT2 inhibitors, often after prolonged therapy. Understanding the risk of euDKA in treatment-naive patients is critical, as they may lack the self-management skills to recognize and respond to early symptoms.
Data Highlights
No numerical or trial data provided in the article.
Key Findings
Severe euDKA can occur within 4 days of initiating SGLT2 inhibitors in treatment-naive patients.
Common gastrointestinal symptoms from metformin can lead to reduced oral intake and dehydration, precipitating euDKA.
The patient presented with high-anion-gap metabolic acidosis, ketonemia, and normal plasma glucose levels.
Management included intravenous dextrose, insulin infusion, and fluid resuscitation, with resolution by day 3.
Patient education and monitoring are essential during the initial weeks of therapy with SGLT2 inhibitors.
Clinical Implications
Healthcare providers should be aware of the risk of euDKA in treatment-naive patients starting SGLT2 inhibitors, particularly when gastrointestinal side effects from metformin occur.
Conclusion
This case highlights the rapid onset of euDKA in treatment-naive patients.
