Case of Euglycemic Diabetic Ketoacidosis

The podcast episode discusses a case of a patient with euglycemic diabetic ketoacidosis (DKA). The patient initially presented with epigastric pain and slight nausea and was diagnosed with either dyspepsia or functional illness. However, 12 hours later, the patient's symptoms worsened, including increasing epigastric pain, poor appetite, and shortness of breath. The doctor reviewed the patient's lab work, which showed low bicarbonate levels, elevated anion gap, and positive serum ketones. It was discovered that the patient was taking sodium glucose transporter 2 (SGLT2) inhibitors, which can lead to euglycemic DKA. The episode highlights the importance of considering this diagnosis when encountering patients on SGLT2 inhibitors with gastrointestinal symptoms and shortness of breath.