Case Report: Early-onset euglycemic diabetic ketoacidosis following henagliflozin initiation in a treatment-naive patient - Takeaways - MDSpire

Case Report: Early-onset euglycemic diabetic ketoacidosis following henagliflozin initiation in a treatment-naive patient

  • By

  • Jing Cai

  • Tiantian Fu

  • Cuixia Tan

  • July 7, 2026

  • 0 min

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  • 1

    SGLT2 inhibitors can cause euglycemic diabetic ketoacidosis (euDKA) typically after ≥2 weeks of therapy, but early-onset cases in treatment-naive patients are poorly characterized.

  • 2

    A 40-year-old woman developed severe euDKA within 4 days of starting henagliflozin, precipitated by metformin-induced gastrointestinal symptoms.

  • 3

    The patient presented with severe metabolic acidosis and ketonemia, with plasma glucose levels consistent with euDKA despite low glucose readings.

  • 4

    Management included intravenous dextrose, insulin infusion, and fluid resuscitation, leading to resolution of euDKA by day 3.

  • 5

    This case highlights the need for enhanced patient education and monitoring during the initial weeks of therapy for treatment-naive patients.

Original Source(s)

Case Report: Early-onset euglycemic diabetic ketoacidosis following henagliflozin initiation in a treatment-naive patient

  • by Jing Cai, Tiantian Fu, Cuixia Tan

  • July 7, 2026

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