Euglycemic Diabetic Ketoacidosis
Michael C. Plewa, M G Bryant, Robin King-Thiele
Abstract
Euglycemic DKA (EDKA) is a clinical syndrome occurring both in type 1 (T1D) or type 2 (T2D) diabetes mellitus characterized by euglycemia (blood glucose less than 250 mg/dL) in the presence of severe metabolic acidosis (arterial pH less than 7.3 and serum bicarbonate less than 18 mEq/L) and ketonemia. DKA is one of the most severe and life-threatening complications of diabetes mellitus and can be seen in a variety of conditions. The incidence of EDKA, however, has grown with the introduction of sodium-glucose transporter 2 (SGLT2) inhibitors. It also presents a diagnostic challenge for physicians due to the variety of etiologies and normal blood glucose levels, often resulting in delayed diagnosis.