Case Report: Euglycemic ketoacidosis in a non-diabetic patient: a rare adverse effect of SGLT2 inhibitor therapy.

ABSTRACT:

Background

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are increasingly prescribed for heart failure and chronic kidney disease, irrespective of diabetic status. While their cardiovascular and renal benefits are well established, euglycemic ketoacidosis (EKA) remains a rare but potentially life-threatening complication that can occur even in non-diabetic individuals.

Case presentation

We report a 58-year-old man with ischemic cardiomyopathy (LVEF 35%) and stage 2 chronic kidney disease who developed nausea, vomiting, and fatigue two weeks after initiating dapagliflozin. Laboratory evaluation revealed high-anion-gap metabolic acidosis (pH 7.21 [reference: 7.35-7.45], HCO₃ ^- 12 mmol/L [reference: 22-28 mmol/L], anion gap 23 mmol/L [reference: 8-16 m

SUBMITTER: Prasad S 

PROVIDER: S-EPMC12855120 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature