A Case Report of Diabetic Ketoacidosis With Combined Use of a Sodium Glucose Transporter 2 Inhibitor and Hybrid Closed-Loop Insulin Delivery

摘要

Since the approval of sodium glucose transporter 2 (SGLT-2) inhibitors, case reports have described euglycemic diabetic ketoacidosis (eDKA). When used off-label in people with type 1 diabetes, eDKA may result when patients fail to administer extra insulin in response to an acute precipitant. The introduction of the first hybrid closed-loop insulin delivery system—MiniMed 670G—allows insulin pump users with type 1 diabetes to receive automatically-adjusting basal insulin delivery. We report a case of a woman with type 1 diabetes using an SGLT-2 inhibitor who presented with eDKA after starting hybrid closed-loop insulin delivery.