SGLT2 inhibitor-associated euglycemic ketoacidosis after percutaneous coronary intervention for ST-segment elevation myocardial infarction

This case highlights that euglycemic diabetic ketoacidosis (euDKA) might be a critical and missed diagnosis in SGLT2 inhibitor-treated diabetic patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). SGLT2 inhibitor-associated euDKA should be considered in diabetic patients presenting with unexplained metabolic acidosis, even if they are hemodynamically stable and their blood glucose levels are normal. Routine ketone monitoring should be considered in this setting.