Euglycemic diabetic ketoacidosis due to small bowel perforation: a case report

Submitted: 8 April 2024
Accepted: 3 June 2024
Published: 19 June 2024
Abstract Views: 282
PDF: 252
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Diabetic Ketoacidosis (DKA) is a potentially life-threatening condition that complicates diabetes mellitus. Euglycemic DKA (eDKA) is emerging as a variant in both type 1 and type 2 diabetes mellitus. The rise in its presentation is being caused by newer medicines using SGLT-2 inhibitors, with a complex underlying pathophysiology. Here we report a case of a 70-year-old woman presenting to the emergency department complaining of shortness of breath and abdominal pain. She suffers from type 2 diabetes mellitus and is on oral therapy, including the SGLT-2 inhibitor empagliflozin. Further testing revealed a high-anion-gap metabolic acidosis without elevation of lactate levels and a glucose level of 160 mg/dL. CT imaging of the abdomen showed a small bowel perforation. The case required aggressive medical therapy before surgical repair in the operating room. EDKA is a medical emergency that can be challenging to identify due to its atypical presentation compared to the traditional DKA (which is hyperglycemic). These characteristics can delay effective and timely treatment.

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Citations

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How to Cite

Fornaciari, L., Bondavalli, L., & Mulas, C. S. (2024). Euglycemic diabetic ketoacidosis due to small bowel perforation: a case report. Emergency Care Journal, 20(2). https://doi.org/10.4081/ecj.2024.12551