Euglycaemic ketoacidosis from an SGLT2 inhibitor exacerbated by a ketogenic diet

Shampa Sinha, Daniel Gavaghan and Steven Yew
Med J Aust 2020; 212 (1): . || doi: 10.5694/mja2.50434
Published online: 13 January 2020

To the Editor: A 64‐year‐old woman presented to our emergency department with progressively reduced consciousness over 3 days. This was preceded by 2 days of vomiting and diarrhoea. She had been systemically well before this, with no acute medical issues. She had type 2 diabetes and had been commenced on combination 10 mg empagliflozin and 5 mg linagliptin a year ago after having experienced diarrhoea with metformin. Her most recent glycated haemoglobin level was 58 mmol/mol (reference interval [RI], 20–42 mmol/mol). She had also been trialling the Atkins diet for about 2 months before presentation.

  • Shampa Sinha
  • Daniel Gavaghan
  • Steven Yew

  • Royal Hobart Hospital, Hobart, TAS


Competing interests:

No relevant disclosures.


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