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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2021; 12(5): 514-523
Published online May 15, 2021. doi: 10.4239/wjd.v12.i5.514
Published online May 15, 2021. doi: 10.4239/wjd.v12.i5.514
Euglycemic diabetic ketoacidosis: A missed diagnosis
Prashant Nasa, Aanchal Singh, Department of Critical Care Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Sandeep Chaudhary, Department of Endocrinology, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Pavan Kumar Shrivastava, Department of Internal Medicine, NMC Specialty Hospital, Dubai 7832, United Arab Emirates
Author contributions: Nasa P and Chaudhary S contributed equally to this work; Nasa P, Chaudhary S, Shrivastava PK and Singh A designed the research study; Nasa P and Chaudhary S searched and reviewed the literature; Nasa P conceptualized and designed the figure; All authors have read and approved the final manuscript.
Conflict-of-interest statement: Prashant Nasa has received fees for serving as an advisory board member for Edward Life Sciences. Other authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prashant Nasa, MD, Head of the Department, Department of Critical Care Medicine, NMC Specialty Hospital, Al Nahda 2, Dubai 7832, United Arab Emirates.
Received: January 22, 2021
Peer-review started: January 22, 2021
First decision: February 25, 2021
Revised: March 1, 2021
Accepted: March 25, 2021
Article in press: March 25, 2021
Published online: May 15, 2021
Processing time: 104 Days and 8.2 Hours
Peer-review started: January 22, 2021
First decision: February 25, 2021
Revised: March 1, 2021
Accepted: March 25, 2021
Article in press: March 25, 2021
Published online: May 15, 2021
Processing time: 104 Days and 8.2 Hours
Core Tip
Core Tip: Euglycemia diabetic ketoacidosis (DKA) is an uncommon, life-threatening emergency with lower normal blood glucose. Euglycemic DKA can occur in both types of diabetes mellitus, and the absence of hyperglycemia may delay diagnosis with worse outcomes. The use of sodium/glucose cotransporter-2 (SGLT-2) inhibitors as a therapeutic option in the management of diabetes mellitus has increased the incidence of euglycemic DKA. Euglycemic DKA should be considered in any unexplained metabolic acidosis with a history of diabetes mellitus and associated risk factors. Patients on SGLT-2 inhibitors must be educated about potential risk factors for euglycemic DKA and dose adjustment for sick days.