Case Report: Chest Pain as an Uncommon Presentation for Euglycemic Diabetic Ketoacidosis in a Female Patient Using SGLT2 inhibitor

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are well-recognised antidiabetic medications among clinicians due to its highly protective effects on cardiovascular and renal systems diabetic patients. However, one of uncommonly reported side is the development euglycemic ketoacidosis (EuDKA) which characterized by mild hyperglycemia, ketosis acidosis. Chest pain as a clinical presentation EuDKA has been rarely in literature. We present case 46-year-old female with past medical history type 2 diabetes mellitus (T2DM), hypertension, hypertriglyceridemia presented hospital central chest that radiates back associated shortness breath bout vomiting. She had taking dapagliflozin, an SGLT2 inhibitor, for four years. was found have blood glucose level 7 mmol\L, high anion gap metabolic acidosis ketonuria. Toxicology screening unremarkable. diagnosed SGLT2-induced treated fluid, insulin potassium chloride (KCL). Her course went smoothly. Dapagloflzi discontinued, she discharged home oral metformin subcutaneous insulin. This study highlights rare occurance EuDKA, uncommon effect widely used inhibitors. patients using Inhibitors should raise clinician's suspicion possible EuDKA.