Case Report
Euglycemic Diabetic Ketoacidosis in a Sedated Patient after Coronary Artery Bypass Grafting: A Case Report and Literature Review
Table 3
Reported cases of EDKA after CABG.
| | Author (year) | Age (years) | Gender | Comorb | Risk factor/s (mg) | Hours since gliflozin was withheld before CABG | Time between CABG and EDKA | Clinical presentation | BG (mg/dL) | pH | Blood ketones (mmol/L) | Anion gap (mmol/L) | Ketones in urine | Lactate (mmol/L) | Other T2DM medications |
| | Lau et al. (2018) [13] | 54 | M | T2DM | Empagliflozin (25) | 48 | Hours | Nausea, vomiting, tachypnea | 216 | 7.24 | 5.26 (b-HB) | 15 | N/A | 1.1 | NPH insulin | | 58 | M | T2DM | Empagliflozin (25) | 28 | Next day | Tachypnea | 111.6 | 7.30 | 4.63 (b-HB) | 14 | Present | 1.4 | Metformin, gliclazide | | 54 | M | T2DM | Empagliflozin (25) | 20 | Next day | Nausea, tachypnea | 172.8 | 7.33 | 0.98 (b-HB) | 12 | Present | 2.8 | Metformin |
| | Chacko et al. (2018) [14] | 66 | F | T2DM, HTN, obesity, anxiety disorder | Dapagliflozin (N/A) | N/A | 20 hours | N/A | 165.6 | 7.26 | 1.8 | N/A | N/A | 1.13 | Saxagliptin, metformin |
| | Zhang et al. (2018) [15] | 70 | M | T2DM, PAF, DL | Empagliflozin (N/A) | N/A | Few days | Nausea, vomiting, weakness | 201.6 | 7.27 | >3.2 (b-HB) | 31 | Present | Normal | Metformin, liraglutide, modified release gliclazide |
| | Osafehinti et al. (2021) [16] | 60 | M | T2DM, HC | Empagliflozin (10) | 42 | Hours | N/A | 138 | 7.275 | 6.52 (b-HB) | 25 | N/A | Normal | Glimepiride, metformin, semaglutide |
| | Pontes et al. (2021) [17] | 57 | M | T2DM | Dapagliflozin (10) | 24 | Next day | Tachypnea, restlessness, polydipsia, polyuria | 151–248 | 7.21 | N/A | 30 | Present | 2.24 | Basal insulin |
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Comorb: comorbidities; CABG: coronary artery bypass grafting; EDKA: euglycemic DKA; BG: blood glucose; T2DM: type 2 diabetes mellitus; b-HB: b-hydroxybutyrate; HTN: hypertension; PAF: paroxysmal atrial fibrillation; DL: dyslipidemia; HC: hypercholesterolemia; N/A: not available.
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