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Abstract
A case of euglycemic diabetic ketoacidosis was reported in a patient on tirzepatide monotherapy, with no concurrent SGLT2 inhibitor use.
- Symptoms included nausea, vomiting, and abdominal pain.
- Laboratory findings indicated severe metabolic acidosis with a CO₂ level of 7 mmol/L, an anion gap of 28, and a pH of 7.1.
- Mild hyperglycemia was observed, with a glucose level of 167 mg/dL.
- Management included intravenous fluids, dextrose, and insulin infusion, leading to resolution of the anion gap.
- The case suggests a potential link between tirzepatide and euglycemic diabetic ketoacidosis, possibly due to mechanisms involving starvation ketosis and reduced insulin availability.
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