Sodium-glucose Cotransporter-2 Induced Diabetic Ketoacidosis with Minimal Hyperglycemia.

The case of a 56-year-old man with a history of type 2 diabetes mellitus who presented to the emergency department in diabetic ketoacidosis (DKA) with only mild hyperglycemia is presented. The patient was taking empagliflozin (Jardiance®), a sodium-glucose cotransporter -2 inhibitor, which has now been recognized as causing this unusual presentation of DKA. Emergency physicians need to be aware of this complication, as the euglycemia/mild hyperglycemia and a history of type 2 diabetes mellitus can make the correct diagnosis of DKA a challenge.