Abstract：
Euglycemic diabetic ketoacidosis (euDKA) is a rare but life-threatening adverse effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors. We present a case of delayed euDKA seven days after cure of acute pancreatitis and discharge from the hospital of a 51-year-old man with type 2 diabetes mellitus (T2DM) managed with a combination of antidiabetic medications, including the SGLT2 inhibitor dapagliflozin. Prior acute pancreatitis was postulated to be a contributing factor to the development of SGLT2 inhibitor-associated euDKA in this patient discharged from the hospital. The patient was managed accordingly and improved clinically while his oral hypoglycemic agents were stopped. The risk of euDKA from SGLT2 inhibitor therapy may be increased by some stress factors (eg, infection, surgery, acute illness, low-carbohydrate diet, excessive alcohol intake). As these SGLT2 inhibitors become a popular therapeutic strategy for the management of hyperglycemia in T2DM, clinicians should be aware that acute illnesses such as pancreatitis in patients with T2DM can be potential predisposing factors for the development of SGLT2 inhibitor-associated euDKA.
摘要：
正常血糖糖尿病酮症酸中毒（euDKA）是钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂的一种罕见但危及生命的不良反应。我们介绍了一例急性胰腺炎治愈7天后延迟eDKA的病例，一名51岁的2型糖尿病（T2DM）患者出院后，联合使用抗糖尿病药物治疗，包括SGLT2抑制剂达格列净。先前的急性胰腺炎被认为是该出院患者中SGLT2抑制剂相关euDKA发展的促成因素。在停用口服降血糖药的同时，患者得到了相应的治疗和临床改善。来自SGLT2抑制剂治疗的euDKA的风险可能因一些应激因素而增加（例如，感染,手术,急性疾病,低碳水化合物饮食,过量饮酒)。随着这些SGLT2抑制剂成为治疗T2DM高血糖的流行治疗策略，临床医生应注意,T2DM患者的急性疾病如胰腺炎可能是SGLT2抑制剂相关euDKA发生的潜在诱发因素.
