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Euglycemic Ketoacidosis

  • Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
  • Published:
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Abstract

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.

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Authors and Affiliations

  1. Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy

    Benedetta Maria Bonora, Angelo Avogaro & Gian Paolo Fadini

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  1. Benedetta Maria Bonora
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  2. Angelo Avogaro
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Correspondence to Gian Paolo Fadini.

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Bonora, B.M., Avogaro, A. & Fadini, G.P. Euglycemic Ketoacidosis. Curr Diab Rep 20, 25 (2020). https://doi.org/10.1007/s11892-020-01307-x

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