Purpose of Review

Diabetic ketoacidosis is a life-threatening complication of diabetes characterized by hyperglycemia, acidosis, and ketosis. Ketoacidosis may occur with blood glucose level < 200 mg/dl (improperly defined as euglycemic ketoacidosis, euKA) and also in people without diabetes. The absence of marked hyperglycemia can delay diagnosis and treatment, resulting in potential serious adverse outcomes.

Recent Findings

Recently, with the wide clinical use of sodium glucose co-transporter 2 inhibitors (SGLT2i), euKA has come back into the spotlight. Use of SGLT2i use can predispose to the development of ketoacidosis with relatively low or normal levels of blood glucose. This condition, however, can occur, in the absence of diabetes, in settings such as pregnancy, restriction on caloric intake, glycogen storage diseases or defective gluconeogenesis (alcohol abuse or chronic liver disease), and cocaine abuse.

Summary

euKA is a challenging diagnosis for most physicians who may be misled by the presence of normal glycemia or mild hyperglycemia. In this article, we review pathophysiology, etiologies, clinical presentation and the management of euKA.

中文翻译：

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正常血糖酮症酸中毒。

审查目的

糖尿病性酮症酸中毒是威胁生命的糖尿病并发症，其特征是高血糖症，酸中毒和酮症。血糖水平低于200 mg / dl时可能会发生酮症酸中毒（不当定义为正常血糖酮症酸中毒，euKA），而且在没有糖尿病的人群中也可能发生。没有明显的高血糖会延迟诊断和治疗，导致潜在的严重不良后果。

最近的发现

近年来，随着钠葡萄糖共转运蛋白2抑制剂（SGLT2i）的广泛临床应用，euKA再次受到关注。SGLT2i的使用可以使酮症酸中毒的血糖水平相对较低或正常。然而，在没有糖尿病的情况下，这种状况可能发生在诸如怀孕，热量摄入受限，糖原贮积疾病或糖异生不良（酒精滥用或慢性肝病）以及可卡因滥用等环境中。

概要

对于可能被正常血糖或轻度高血糖症误导的大多数医师而言，euKA是一项具有挑战性的诊断。在本文中，我们回顾了euKA的​​病理生理，病因，临床表现和管理。