Raising awareness of the link between sodium glucose co-transporter 2 inhibitors and euglycaemic diabetic ketoacidosis – an important perioperative consideration

Background: Diabetic ketoacidosis (DKA) is a well-recognised medical emergency defined as a biochemical triad of metabolic acidosis, ketosis, and hyperglycaemia. However, when associated with the use of sodium glucose co-transporter 2 (SGLT2) inhibitors, it can pose a diagnostic challenge, presenting without hyperglycaemia as euglycaemic DKA (EDKA).1 Surgery is one of many recognised precipitating factors for this complication, and so it is recommended that SGLT2 inhibitors be withheld during illness and the perioperative period.