Sodium-glucose cotransporter 2 inhibitor-induced euglycaemic diabetic ketoacidosis in heart failure with preserved ejection fraction.
The number of patients receiving sodium-glucose cotransporter 2 inhibitors (SGLT2is), especially those with heart failure, is increasing worldwide. SGLT2is control glycaemia by triggering glycosuria with simultaneous facilitation of a more ketogenic metabolic profile. Patients therefore are more prone to develop euglycaemic diabetic ketoacidosis (euDKA), an entity largely unknown beyond diabetes care professionals. We present a heart failure with preserved ejection fraction (HFpEF) patient with known Type 2 diabetes. He was treated with dapagliflozin and presented acutely with dyspnoea, hyperglycaemia, and ketoacidosis. After standard treatment for diabetic ketoacidosis, hyperglycaemia was corrected, while metabolic ketoacidosis persisted, and thus, euDKA was suspected. With adequate therapy, the patient recovered completely and was discharged without any sequelae. To the best of our knowledge, our case is the first to describe SGLT2i-induced euDKA in HFpEF patients. Regarding no previous reports of euDKA in heart failure with reduced ejection fraction, our report is highly relevant for ongoing SGLT2i trials in HFpEF and clinical practice in general.
['Cavka|Luka|L|', 'Bencak Ferko|Urska|U|', 'Pitz|Natasa|N|', 'Trpkovski|Zoranco|Z|', 'Lainscak|Mitja|M|']
D001786:Blood Glucose D003924:Diabetes Mellitus, Type 2 D016883:Diabetic Ketoacidosis D006333:Heart Failure D006801:Humans D008297:Male D012964:Sodium D000077203:Sodium-Glucose Transporter 2 Inhibitors D013318:Stroke Volume
Euglycaemic diabetic ketoacidosis Diabetic ketoacidosis Heart failure SGLT2 inhibitor