Abstract
A 35-year-old man was admitted to the hospital with symptoms of excessive thirst, polyuria, and nausea that had persisted for one month. He was diagnosed with type 2 diabetes and treatment was initiated with metformin (750 mg/day) and empagliflozin (10 mg/day). Immediately after the administration of these drugs, he became unable to eat or take his medication due to severe nausea and vomiting and was subsequently admitted to our emergency room. The patient was diagnosed with diabetic ketoacidosis (DKA) based on his history and clinical data, and was treated with continuous intravenous insulin infusion. However, his ketosis persisted until day 6. His serum concentration of empagliflozin was detectable on both the fourth and fifth days, suggesting that a pharmacological effect of empagliflozin may have caused the delayed recovery from ketosis. It is necessary to consider the possibility that, in addition to inducing DKA, SGLT2 inhibitors may also cause a delay in recovery from ketosis.
