Re-emergence of a forgotten diabetes complication: Euglycemic diabetic ketoacidosis
Turkish Journal of Emergency Medicine, cilt.24, sa.1, ss.1-7, 2024 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 24 Sayı: 1
- Basım Tarihi: 2024
- Doi Numarası: 10.4103/tjem.tjem_110_23
- Dergi Adı: Turkish Journal of Emergency Medicine
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.1-7
- Anahtar Kelimeler: Diabetes mellitus, diabetic ketoacidosis, sodium-glucose transporter 2 inhibitors
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Diabetic ketoacidosis (DKA) is the most common emergency complication of diabetes. Euglycemic DKA (EDKA), on the other hand, has been known for many years but is a rare and under‑recognized condition and constitutes a very small proportion of DKA cases. However, in recent years, an increase in the incidence of EDKA has been observed with the widespread use of sodium–glucose co‑transporter 2 inhibitors, which have proven benefits in the treatment of diabetes mellitus and its cardiorenal complications, heart failure, and chronic kidney disease. Unlike classical DKA, these patients without significant hyperglycemia can easily be missed in emergency departments. EDKA should be kept in mind in patients with diabetes presenting with DKA but with a blood glucose level <250 mg/dL. The diagnostic and therapeutic approach after clinical suspicion in these patients is similar to classical DKA and is briefly summarized in this review. The most important point in treatment is that these patients are normoglycemic but have a significant insulin deficiency (relative or absolute). Therefore, insulin is the mainstay of the treatment and should be given together with dextrose solutions to avoid hypoglycemia.