SGLT2-receptor inhibitors-associated euglycemic diabetic ketoacidosis in oncosurgical patients in the early postoperative period: A case report

Abstract

Relevance: Administration of SGLT2-receptor inhibitors in oncosurgical patients with diabetes mellitus could lead to a formidable complication - the development of euglycemic diabetic ketoacidosis (EDKA) - a specific condition that is difficult to diagnose in a wide range of specialists. The lack of information about this complication and, thus, vigilance due to normal glucose levels complicates early detection of EDCA in surgical patients. Regarding oncosurgical patients, data on the prevalence of SGLT2-associated EDCA in the early postoperative period is limited. The presented clinical case highlights the significant risks of intraoperative surgical stress and prolonged fasting in patients on SGLT2 inhibitor therapy, as well as the difficulties in timely recognition of this condition.

This paper aimed to increase the alertness and raise the awareness of clinical specialists about the risk of EDCA development in oncosurgical patients after the administration of SGLT2 inhibitors in the early postoperative period, the importance of timely diagnosis of this condition, and the ways of its treatment, using the described clinical case.

Methods: The article describes a clinical case of an oncosurgical patient who developed EDKA in the early postoperative period as a complication of SGLT2 inhibitors administration.

Results: In the early postoperative period following the administration of Dapagliflozin, the patient developed EDKA, which was successfully managed through adequate hydration with balanced crystalloid solutions, correction of glycaemia with intravenous insulin infusion and 10% glucose solutions, and the correction of acid-base and blood electrolytes balance.

Conclusion: This clinical case demonstrates the importance of early diagnosis and treatment of EDCA as a rare but dangerous complication of SGLT2 inhibitors in oncosurgical patients.