Sodium-glucose co-transporter-2 inhibitor-associated euglycemic diabetic ketoacidosis that prompted the diagnosis of fulminant type-1 diabetes: A case report

Table 1 Laboratory data

Blood cell count		Normal range	Units	Biochemical examination		Normal range	Units	Arterial blood gas analysis (room air)		Normal range	Units
White blood cell	11440	3300-8600	/μL	Total protein	8.2	6.6-8.1	g/dL	pH	7.182	7.350-7.450	mmHg
Red blood cell	489	386-492	× 104/μL	Albumin	4.5	4.1-5.1	g/dL	paCO2	18	35.0-45.0	mmHg
Hemoglobin	14.7	11.6-14.8	g/dL	BUN	9.1	8.0-20.0	mg/dL	paO2	115.2	> 80	mmol/L
Hematocrit	43.6	35.1-44.1	%	Creatinine	0.4	0.46-0.79	mg/dL	HCO3-	6.6	22.0-26.0	mmol/L
Platelet	28.3	15.8-34.8	× 104/μL	Uric acid	5.3	2.6-5.5	mg/dL	Base excess	-19.3	-2.0-+2.0	mmol/L
				Na	131	138-145	mEq/L	Anion gap	27.6	10.0-18.0	mmol/L
Urinalysis				K	4.5	3.6-4.8	mEq/L	Lactic acid	1.0	0.9-1.7	mmHg
Specific gravity	1.015	1.005-1.030		Cl	102	101-108	mEq/L
pH	5.5	4.5-7.5		Ca	8.7	8.8-10.1	mg/dL	Blood ketone bodies
Glucose	2000	< 50	mg/dL	P	2.6	2.7-4.6	mg/dL	Acetoacetate	1784	< 55	μmol/L
Protein	100	< 30	mg/dL	AST	20	13-30	U/L	3-Hydroxybutyrate	6585	< 85	μmol/L
Ketone body	(3+)	(-)		ALT	6	7-23	U/L
Blood	(±)	(-)		LDH	251	124-222	U/L	Autoantibodies
				γ-GTP	43	9-32	U/L	GAD autoantibody	< 5.0	< 5.0	U/mL
Diabetic parameters				ALP	178	106-322	U/L	IA-2 autoantibody	< 0.6	< 0.6	U/mL
HbA1c	7.3	4.9-6.0	%	T-Bil	0.5	0.4-1.5	mg/dL	Insulin autoantibody	< 0.4	< 0.4	U/mL
Glycoalbumin	23.2	11.0-16.0	%	CRP	0.12	< 0.14	mg/dL	Islet cell antibody	(-)	(-)
Blood glucose	184	73-109	mg/dL	Total-cholesterol	242	142-248	mg/dL	ZnT8 autoantibody	< 10.0	< 15.0	U/mL
Serum C-peptide	0.3	0.6-2.1	ng/mL	Triglyceride	230	30-117	mg/dL
Urine C-peptide	8.6	22.8-155.2	μg/d	Amylase	35	44-132	U/L
				Lipase	23	12-51	U/L

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; T-Bil: Total bilirubin; CRP: C-reactive protein; GAD: Glutamic acid decarboxylase; IA-2: Insulinoma-associated protein-2; BUN: Blood urea nitrogen; LDH: Lactate dehydrogenase; HbA1c: Glycated hemoglobin/hemoglobin A1c.