{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:35:01Z","timestamp":1789842901456,"version":"4.0.1"},"reference-count":18,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016646","name":"HCA Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016646","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Euglycemic ketoacidosis (EKA) is a life-threatening condition characterized by ketone production leading to systemic acidosis, dehydration, and end-organ damage. It presents similarly to diabetic ketoacidosis, except that patients have normal to slightly elevated blood glucose levels. EKA is an increasingly recognized complication of sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. Recently the novel dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist tirzepatide was approved for treatment of diabetes and weight loss. Here, we describe a unique case in which a patient placed on both an SGLT2 inhibitor and tirzepatide to treat type 2 diabetes was admitted to the intensive care unit (ICU) for EKA. To our knowledge, this is the first case detailing a patient developing this serious condition after starting tirzepatide for diabetes. The patient required treatment and monitoring in an ICU to make a full recovery. As tirzepatide is a relatively new medication whose side effect profile has yet to be fully characterized, clinicians should be aware of this rare yet potentially fatal complication.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf028","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T04:38:50Z","timestamp":1738384730000},"source":"Crossref","is-referenced-by-count":11,"title":["Euglycemic Ketoacidosis Following Coadministration of an SGLT2 Inhibitor and Tirzepatide"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8741-2240","authenticated-orcid":false,"given":"Eli J","family":"Louwagie","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, LewisGale Hospital Montgomery , Blacksburg, VA 24060 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica N","family":"Diego","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, LewisGale Hospital Montgomery , Blacksburg, VA 24060 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1985-3057","authenticated-orcid":false,"given":"Crystal S","family":"Farooqi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, LewisGale Hospital Montgomery , Blacksburg, VA 24060 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madiha M","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, LewisGale Hospital Montgomery , Blacksburg, VA 24060 ,","place":["USA"]},{"name":"Internal and Academic Medicine, LewisGale Physicians , Christiansburg, VA 24073 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"2025021712065812800_luaf028-B1","first-page":"17-0081","article-title":"Euglycemic diabetic ketoacidosis: a diagnostic and therapeutic dilemma","volume":"2017","author":"Rawla","year":"2017","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2025021712065812800_luaf028-B2","volume-title":"Euglycemic Diabetic Ketoacidosis","author":"Plewa","year":"2023"},{"key":"2025021712065812800_luaf028-B3","doi-asserted-by":"crossref","first-page":"k4365","DOI":"10.1136\/bmj.k4365","article-title":"Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study","volume":"363","author":"Ueda","year":"2018","journal-title":"BMJ"},{"issue":"4","key":"2025021712065812800_luaf028-B4","doi-asserted-by":"crossref","first-page":"919","DOI":"10.2337\/dc21-2177","article-title":"Comparative safety of sodium-glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitors and sulfonylureas on the risk of diabetic ketoacidosis","volume":"45","author":"Dawwas","year":"2022","journal-title":"Diabetes 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