The Illusion of Stability: Deglycemized Diabetic Ketoacidosis in Ambulatory Care With Long-Term SGLT2 Inhibitor Use

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become a cornerstone of contemporary type 2 diabetes management because of their established glycemic, cardiovascular, and renal benefits. However, growing evidence has demonstrated an association between SGLT2 inhibitor therapy and diabetic ketoacidosis (DKA), frequently presenting with attenuated or only modest hyperglycemia, a phenomenon now recognized as euglycemic DKA.1,2