Abstract：
Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower glucose levels by reducing glucose reabsorption in the kidneys, which can lead to ketogenesis. Euglycemic diabetic ketoacidosis (DKA) is a rare but potentially life-threatening complication of SGLT2 inhibitors that can be triggered by trauma. However, the absence of significant hyperglycemia can delay its diagnosis and treatment, which may lead to detrimental consequences. Herein, we report a case of euglycemic DKA following traumatic brain injury in a patient with type 2 diabetes who was taking an SGLT2 inhibitor. Delayed recognition of euglycemic DKA in this case led to progressive metabolic deterioration. This report emphasizes the importance of promptly suspecting, diagnosing, and treating euglycemic DKA in patients with traumatic injuries who exhibit high anion-gap metabolic acidosis, ketonuria, and glucosuria-even if they do not have significant hyperglycemia.
摘要：
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂通过减少肾脏中的葡萄糖重吸收来降低葡萄糖水平，会导致酮生成。正常血糖糖尿病酮症酸中毒（DKA）是SGLT2抑制剂的一种罕见但可能危及生命的并发症，可由创伤引发。然而,没有明显的高血糖会延迟其诊断和治疗，这可能会导致不利的后果。在这里，我们报道了1例2型糖尿病患者在接受SGLT2抑制剂的创伤性脑损伤后出现正常血糖DKA的病例.在这种情况下，对正常血糖DKA的延迟识别导致进行性代谢恶化。这份报告强调了及时戒备的重要性,诊断,并治疗表现出高阴离子间隙代谢性酸中毒的创伤性损伤患者的正常血糖DKA，酮尿症,和糖尿-即使他们没有明显的高血糖。
