Euglycemic Ketoacidosis Diagnosis and Treatment Protocol in Type 1 Diabetes Patient

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Abstract

Introduction. The introduction of sodium glucose cotransporter 2 inhibitors in the management of diabetes was an innovation in the treatment of this disease, considering the protective cardiovascular effect not only the ability of decreasing the plasma glucose. In Europe, this class of medication is approved for the treatment of type 2 diabetes and some of them (dapagliflozin and sotagliflozin) are also approved for use in certain patients with type 1 diabetes mellitus. These patients must have inadequate control of their blood glucose levels despite optimal insulin therapy. One of the adverse effects is diabetic ketoacidosis.

Case report. This case report presents a diabetic patient whose treatment was changed from insulin therapy to oral therapy. Within 10 days after the initiation of the new treatment her condition gradually worsened and she arrived at the emergency room with nausea, vomiting and altered general condition. She was admitted for euglycemic ketoacidosis and treated according to the protocol.

Conclusions. This case reveals the importance of continuing the insulin therapy when adding a sodium glucose cotransporter 2 inhibitor in type 1 diabetes patients.

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