Clinical Practice and Cases in Emergency Medicine

Introduction: Recently, euglycemic diabetic ketoacidosis has been an increasing topic of discussionwithin emergency medicine literature. Euglycemic diabetic ketoacidosis can easily be missed, as anormal point-of-care glucose often mistakenly precludes the work-up of diabetic ketoacidosis.

Case Report: A 16-year-old female with a past medical history of type 1 diabetes presented tothe emergency department with altered mental status, vomiting, and abdominal pain. She wasdiagnosed with euglycemic diabetic ketoacidosis.

Conclusion: Reported cases of euglycemic diabetic ketoacidosis are most frequently attributedto sodium glucose cotransporter-2 inhibitors, but other potential causes have been discussed inthe literature. In this patient, a starvation state with continued insulin use in the setting of acuteappendicitis led to her condition.