Euglycemic Diabetic Ketoacidosis, Recurrent Genital Abscess, and Proximal Renal Tubular Acidosis With Concurrent SGLT-2 Inhibitor: More Than an Association.

Sodium-glucose transport protein 2 (SGLT2) inhibitors are a class of antidiabetic medications that have tremendous benefits in diabetic patients through reducing renal tubular glucose reabsorption, therefore inducing a rapid increase in urinary glucose excretion, thus reducing the overall serum blood glucose. However, the medication's use has commonly been associated with emerging complications such as euglycemic diabetic ketoacidosis (eDKA), a rare and life-threatening metabolic disturbance. Other complications that have been associated with this class of medications are recurrent genital abscesses and renal tubular acidosis, which have both been less reported and explored. Below, we detail the case of a woman who was on empagliflozin, an SGLT2 inhibitor, for only two months and developed life-threatening eDKA, recurrent genital abscesses, and proximal renal tubular acidosis all within the two months of initiation of the medication.