Euglycemic Diabetic Ketoacidosis: From Basics to Clinical
Practice - Review Article
Reungsang BW¹, Charoensri S, MD², Pongchaiyakul C, MD²
Affiliation : ¹ Medical student; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand ² Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Euglycemic diabetic ketoacidosis (DKA) is a life-threatening endocrinological emergency characterized differently from its typical
counterpart by normalized or slightly elevated plasma levels of glucose, defined as less than 200 mg per dL, which can result
in a delay of diagnosis and treatment. This condition can occur in both type 1 and type 2 diabetes mellitus. Common causes
of euglycemic DKA include prescription and use of sodium glucose cotransporter-2 inhibitors (SGLT-2i), pregnancy, glycogen
storage diseases, diet restriction, starvation, and states of stress such as post-operative states, acute pancreatitis, infections,
and intercurrent illnesses. As with DKA, patients with euglycemic DKA also require immediate emergency evaluation and
treatments including rapid correction of dehydration along with correction of electrolytes and use of continuous intravenous
insulin with a dextrose infusion until the blood glucose is controlled, the wide anion gap metabolic acidosis is resolved, and the
ketone values are normalized. This article includes the definition, epidemiology, pathogenesis, diagnosis, differential diagnosis,
and management of euglycemic DKA to enlighten clinicians on the awareness of this condition.
Received 24 Oct 2019 | Revised 27 Dec 2019 | Accepted 2 Jan 2020
Keywords : Euglycemia, Acidosis, Diabetes, Emergency, Sodium glucose co-transportor-2 inhibitors
All Articles
Download