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The sodium\u2010glucose transport protein 2 inhibitors used in the management of type 2 diabetes mellitus may present with ketoacidosis with normal glucose levels. Ketoacidosis with these medications may be prolonged and recur after initial resolution. Checkpoint inhibitors may present with fulminant diabetic ketoacidosis in individuals with previously normal glucose tolerance. Ketoacidosis may also occur as a result of starvation and alcohol excess, as well as a number of rare causes. Other causes of metabolic acidosis with both high and normal anion gap need to be considered in the differential diagnosis of ketoacidosis. Diabetic ketoacidosis may also present with biochemical changes suggestive of myocardial ischaemia and pancreatitis in the absence of these pathologies. The present paper reviews ketone body metabolism, ketone testing and the causes and differential diagnosis of ketoacidosis with particular relevance to emergency medicine.<\/jats:p>","DOI":"10.1111\/1742-6723.13503","type":"journal-article","created":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T05:01:46Z","timestamp":1586322106000},"page":"371-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Review article: Ketoacidosis in the emergency department"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9887-714X","authenticated-orcid":false,"given":"Adam","family":"Morton","sequence":"first","affiliation":[{"name":"Department of Endocrinology Mater Health Services Brisbane  Brisbane Queensland Australia"},{"name":"Department of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-1171-7"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-7560(199911\/12)15:6<412::AID-DMRR72>3.0.CO;2-8"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004563214540136"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1683"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2011.00768.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004563214564226"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1900\/RDS.2016.13.217"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13735"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14347"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2017.05.004"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2015.15123"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13012"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-1380"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2019.04.021"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1530\/EDM-17-0177"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2324709617710040"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dbi18-0002"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.24869\/psyd.2017.121"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.6.922"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2019.1561270"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000166795"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)91750-0"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14207"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-014-9704-9"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13276"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.017590"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-203263"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-216961"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-6614-4-8"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.13245"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.71.831.32"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X15612330"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2018.06.003"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13730-018-0345-y"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.7.4.381"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-017-0960-3"},{"key":"e_1_2_5_38_1","article-title":"A rare case of persistent lactic acidosis in the ICU: glycogenic hepatopathy and Mauriac syndrome","volume":"2016","author":"Deemer KS","year":"2016","journal-title":"Case Rep. 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