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‘Euglycemic’ Ketoacidosis in a Patient With Type 2 Diabetes Being Treated With Canagliflozin.

OBJECTIVE
Canagliflozin is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor, one of a class of
novel antiglycemic agents that are gaining in popularity in the treatment of diabetes.


METHODS
We describe a case in which a patient experienced difficult-to-treat metabolic ketoacidosis
in the setting of canagliflozin use.


RESULTS
A 52-year-old man with type 2 diabetes mellitus developed profound ketoacidosis without
overt hyperglycemia while taking canagliflozin. Despite initiation of an insulin infusion, the
metabolic acidosis persisted for 3 days.


CONCLUSION
Treatment with canagliflozin was associated with development of euglycemic ketoacidosis.