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VOLUME 21 , ISSUE 11 ( 2017 ) > List of Articles


Canagliflozin-associated diabetic ketoacidosis with lower-than-anticipated glucose levels

Manjusha Agarwal

Keywords : Canagliflozin, diabetic ketoacidosis with lower-than-anticipated glucose levels, euglycemic diabetic ketoacidosis, sodium-glucose co-transporter 2 inhibitors

Citation Information : Agarwal M. Canagliflozin-associated diabetic ketoacidosis with lower-than-anticipated glucose levels. Indian J Crit Care Med 2017; 21 (11):793-795.

DOI: 10.4103/ijccm.IJCCM_328_17

License: CC BY-ND 3.0

Published Online: 01-11-2017

Copyright Statement:  Copyright © 2017; The Author(s).


The Food and Drug Administration has approved the use of sodium-glucose co-transporter 2 (SGLT-2) inhibitors for use in Type II diabetics. These are a relatively new addition to the armamentaria of diabetes management. Postmarketing surveillance is a witness to several side effects, a morbid one being ketoacidosis. Herein is discussed a scenario of a Type II diabetic who presented with substantial ketoacidosis without significant hyperglycemia. The absence of the customary precipitating factors and the presence of a recent introduction of canagliflozin, a SGLT-2 inhibitor to the diabetes prescription, hinted at the causal relationship. Of note, she had never experienced diabetic ketoacidosis in the past prior to commencement of SGLT-2 inhibitor therapy. As clinicians, we need to be aware of the treatment-emergent adverse effect of this relatively new class of diabetic treatment.

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