الملخص الإنجليزي
Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are oral hypoglycemic agents
that have insulin-independent glucose-lowering effects mediated by increasing the renal
excretion of glucose by inhibiting the SGLT2-mediated renal glucose reabsorption.
An increasingly recognized complication induced by SGLT2i is euglycemic diabetic
ketoacidosis (eDKA). Here, we describe the case of a 26-year-old male patient with type
2 diabetes mellitus and morbid obesity. Prior to presentation he was on multiple oral
hypoglycemic agents including SGLT2i. He developed life-threatening severe prolonged
eDKA associated with SGLT2i (Canagliflozin), precipitated by adenovirus infection.
The acidosis was not responding to standard DKA therapy and renal replacement
therapy but was managed effectively with insulin titration based on capillary ketone
measurements. After reviewing the literature on severe prolonged eDKA induced
by SGLT2 and treatment modalities used, we present previously reported cases
similar to ours.
