{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:23:41Z","timestamp":1780514621321,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Euglycemic diabetic ketoacidosis (euDKA) is an increasingly recognized complication of sodium-glucose cotransporter-2 (SGLT2) inhibitor therapy, characterized by severe metabolic acidosis with near-normal blood glucose levels. We report a rare case of a 45-year-old woman with type 2 diabetes mellitus who presented with severe euDKA (pH\u00a06.85, glucose 170\u00a0mg\/dl) following initiation of acetazolamide for glaucoma management. Clinical evaluation revealed profound metabolic acidosis with bicarbonate 1.5\u00a0mmol\/l and anion gap 27\u00a0mmol\/l. Delta ratio calculation (0.64) revealed a mixed high anion gap and normal anion gap metabolic acidosis, indicating dual pathophysiology: ketoacid accumulation from euDKA and acetazolamide-induced renal bicarbonate wasting. Immediate acetazolamide discontinuation combined with aggressive fluid resuscitation, insulin infusion, and sodium bicarbonate resulted in complete metabolic correction by Day 3 without hemodialysis. To our knowledge, this rare combination of SGLT2 inhibitor use and acetazolamide underscores the need for careful medication reconciliation and multidisciplinary communication in diabetic patients to prevent complications.<\/jats:p>","DOI":"10.1093\/omcr\/omag058","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:40:09Z","timestamp":1774356009000},"source":"Crossref","is-referenced-by-count":1,"title":["Severe Euglycemic diabetic ketoacidosis with mixed Acid\u2013Base disorder following acetazolamide initiation in type 2 diabetes: a case report and review of literature"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6465-7418","authenticated-orcid":false,"given":"Saif Khaled Abdalhadi","family":"Azzam","sequence":"first","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences, Palestine Polytechnic University , Wadi Al-Harieh Street, Hebron District, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina Barhoum","family":"Barhoum","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences, Palestine Polytechnic University , Wadi Al-Harieh Street, Hebron District, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salih","family":"AbuRajab","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences, Palestine Polytechnic University , Wadi Al-Harieh Street, Hebron District, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagham Khaled Abdalhadi","family":"Azzam","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Sciences, Faculty of Medicine and Health Sciences, Palestine Polytechnic University , Wadi Al-Harieh Street, Hebron District, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef Abdelqader","family":"Alsaeed","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Department, Palestinian Red Crescent Hospital , Al Salam Street, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rostom","family":"Karajeh","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Department, Palestinian Red Crescent Hospital , Al Salam Street, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musad","family":"Shawar","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Department, Palestinian Red Crescent Hospital , Al Salam Street, Hebron, West Bank P720 ,","place":["State of Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"2026051007064660200_ref1"},{"key":"2026051007064660200_ref2"},{"key":"2026051007064660200_ref3"},{"key":"2026051007064660200_ref4","doi-asserted-by":"publisher","first-page":"104879","DOI":"10.1016\/j.amsu.2022.104879","article-title":"Empagliflozin induced euglycemic diabetic ketoacidosis. 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