Case Reports
Vol. 18 No. 2 (2024)
https://doi.org/10.4081/itjm.2024.1716

Sodium-glucose co-transporter-2 inhibitor-associated non-diabetic ketoacidosis: a case report

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Published: 4 April 2024
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SGLT-2 inhibitor, ketoacidosis, ketogenic diet, empaglifozin, non-diabetic

Authors

Vincenzo Trapanese
vincenzo.trapanese@studenti.unicz.it
https://orcid.org/0009-0002-3432-804X
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Francesco Maruca
Geriatric Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Maria Resilde Natale
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Federica Giofrè
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Francesca Cosentino
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Silvia Sergi
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Giuseppe Armentaro
Geriatric Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Valentino Condoleo
Geriatric Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy.
Franco Arturi
Internal Medicine Unit, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro; Research Centre for the Prevention and Treatment of Metabolic Diseases (CR METDIS), Magna Græcia University of Catanzaro, Italy.

Ketoacidosis is considered an emergency metabolic disorder that can be triggered by starvation and alcohol consumption in addition to diabetes. We described an unusual case of ketoacidosis in a non-diabetic young man who presented to our hospital with a complaint of rapid and shallow breathing, weakness and nausea. Fourteen days back, due to heart failure, he started sodiumglucose co-transporter 2 inhibitors (SGLT2-i) in addition to fumarate bisoprolol, sacubitril/valsartan and eplerenone. Based on clinical examination, ketoacidosis was suspected, although his glucose and glycosylated hemoglobin levels were in range. Overall, based on the clinical and laboratory findings, the diagnosis of euglycemic non-diabetic ketoacidosis due to the use of the SGLT2- i was made and SGLT2-i has been discontinued. Although SGLT2-i are effective and safe drugs, it is advisable to carefully evaluate their use also in non-diabetic patients especially when hepatic fibrosis or incorrect eating habits are present.

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How to Cite



Sodium-glucose co-transporter-2 inhibitor-associated non-diabetic ketoacidosis: a case report. (2024). Italian Journal of Medicine, 18(2). https://doi.org/10.4081/itjm.2024.1716
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