Euglycemic Diabetic Ketoacidosis and Thyroid Storm Occurring During Dapagliflozin Treatment

Euglycemic diabetic ketoacidosis (EDKA) is a type of DKA whose incidence has increased in recent years because of the widespread use of sodium-glucose transport protein 2 inhibitors in diabetes treatment. However, the concomitant occurrence of a thyroid storm is uncommon, easily misdiagnosed and missed, and has a high risk of death. This report described the case of a 46-year-old woman with type 2 diabetes mellitus who used a sodium-glucose transport protein 2 inhibitor to manage her blood glucose levels. Before undergoing hysteroscopic surgery for a uterine mass, she developed EDKA and thyroid storm after experiencing nausea, vomiting, and a high fever with persistent tachycardia. This report summarizes and analyzes the clinical characteristics, diagnosis, and treatment process and outcomes to accumulate clinical experience and improve clinicians' understanding of this acute and life-threatening disease. Timely and appropriate treatment may help reduce the incidence of morbidity and mortality associated with EDKA and thyroid storm.