Abstract
Gliflozins are and will be an increasingly widely used medicine in our society. Their benefits in the treatment of diabetes and in the reduction of cardiovascular and renal morbidity and mortality have been repeatedly demonstrated.
However, in clinical practice, we must also think about possible side effects, especially the risk of developing diabetic ketoacidosis. The case report describes a case of development of this complication in a patient with type 2 diabetes mellitus, which occurred despite early discontinuation of gliflozin two days before the start of fasting.
Prolonged glycosuria after discontinuation of gliflozin, which we observed over a total of eight days, proved to be an important mechanism, despite the patient's normoglycaemia. This effect may lead to the development of euglycaemic ketoacidosis through reduced insulin secretion and stimulation of ketogenesis in high-risk situations.
In this case, we want to draw attention to the need for early discontinuation of the drug before risky situations and the fact that the development of euglycaemic diabetic ketoacidosis can be encountered several days after discontinuation of gliflozin. In this sense, it is necessary to educate the patient and medical staff and instruct them on the need to control ketone bodies in the blood in a situation of developing clinical difficulties, despite normoglycaemia and the fact that risk medication has been discontinued for several days.