{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:16:20Z","timestamp":1790802980735,"version":"4.1.0"},"reference-count":25,"publisher":"Bentham Science Publishers Ltd.","issue":"2","funder":[{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["T32 HL098129"],"award-info":[{"award-number":["T32 HL098129"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CDR"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n<jats:title>Introduction:<\/jats:title>\n<jats:p>Sodium-glucose cotransporter-2 [SGLT2] inhibitors reduce cardiovascular\nevents and mortality in patients with diabetes, particularly patients with established cardiovascular disease.\nEuglycemic diabetic ketoacidosis [euDKA], a complication of SGLT2 therapy, can be exacerbated\nby a low carbohydrate diet.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Case Report:<\/jats:title>\n<jats:p>A 61-year-old man with a history of type 2 diabetes, taking an SGLT2 inhibitor empagliflozin\n10 mg orally daily, presented to the emergency room with a 2-day history of nausea and chest\npain. A week prior to presentation, he had started a ketogenic diet. He was initially admitted with a diagnosis\nof acute coronary syndrome. On initial assessment in the emergency room, his cardiac enzymes\nwere normal and there were no ischemic changes in his ECG. As there was concern for unstable angina,\nhe underwent cardiac catheterization, which showed a known total occlusion with collaterals and arteries\nwith a non-obstructive disease without any evidence of acute plaque rupture. His baseline laboratory\nassessments revealed an elevated anion gap of 17, increased urinary and plasma ketones, and metabolic\nacidosis. His plasma glucose level was 84 mg\/dL. The diagnosis of euDKA was made, and treatment\nwith intravenous fluids and insulin was initiated. His chest pain and nausea subsequently resolved.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p>We present a case of euDKA triggered by a ketogenic diet while on SGLT2 inhibitor therapy\npresenting as chest pain. The recognition of euDKA is important in the context of increased SGLT2\nuse for the management of cardiovascular risk for patients with diabetes.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1573399816666200316112709","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T13:48:00Z","timestamp":1584366480000},"page":"243-246","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A Case Report: Euglycemic Diabetic Ketoacidosis Presenting as Chest Pain in a Patient on a Low Carbohydrate Diet"],"prefix":"10.2174","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8340-7863","authenticated-orcid":true,"given":"Brenda","family":"Dorcely","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Nitis","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons-Columbia University, New York, NY 10032,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Schwartzbard","sequence":"additional","affiliation":[{"name":"Center for Prevention of Cardiovascular Disease, New York University School of Medicine, New York, NY, 10016,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Newman","sequence":"additional","affiliation":[{"name":"Center for Prevention of Cardiovascular Disease, New York University School of Medicine, New York, NY, 10016,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Sum","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, NYU Langone Health, New York, NY 10016,United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref=1","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","volume":"373","author":"Zinman B.","year":"2015","unstructured":"Zinman B.; Wanner C.; Lachin J.M.; Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. 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