SGLT2 Inhibitors and Euglycemic DKA Risk factors for euglycemic DKA in those on an SGLT2i include: • Increased insulin requirement (illnesses and surgery) • Insulin deficiency • Severe dehydration • Decreased carbohydrate intake • Excessive alcohol consumption Diagnostic criteria include: • Serum pH ≤ 7.3 • Serum bicarbonate ≤ 15 • Anion gap > 12 • Ketones in serum or urine Treatment involves early recognition along with the following: • Correction of dehydration • Correction of electrolyte abnormalities, specifically hyper/hypoK • Consideration of insulin therapy in severe cases • Maintenance of a glucose of 12-15 mmol until the anion gap is closed • SGLT2 inhibitor should be held immediately Kat Watson @Kat_Watson #SGLT2 #Euglycemic #DKA #EDKA #Toxicity #Toxicology
