[Perioperative Ketoacidosis under SGLT2-Inhibitors]

Abstract

Sodium-glucose cotransporter-2-inhibitors are relatively new substances for treating patients with diabetes mellitus. Not least because of their rare, but severe side effects - especially euglycemic ketoacidosis - anaesthesiologists and physicians in intensive care should know about the pharmacologic properties and risk profile of sodium-glucose cotransporter-inhibitors. The present case report demonstrates typical laboratory findings of severe euglycemic ketoacidosis in a patient with only unspecific symptoms under therapy with gliflozins in the perioperative period. It describes the diagnostic and therapeutic steps and emphasizes the importance of withholding the substances under catabolic conditions. Especially in the perioperative setting it is highly relevant to consider euglycemic ketoacidosis as a differential diagnosis in the presence of a metabolic acidotic state, because a delayed diagnosis and treatment could be life-threatening for the affected person.