Nursing Care for Patients with Euglycemic Diabetic Ketoacidosis After Cardiac Surgery: A Case Report

Objective euDKA is a fatal complication of diabetes, but its symptoms overlap with common symptoms after cardiac surgery and are not easily detected. euDKA associated with SGLT2i was reported, highlighting the importance of recognizing novel hypoglycemic agents for this condition in different populations. Methods We describe the management of a 58-year-old diabetic man who developed severe nonhyperglycemic ketoacidosis after cardiac surgery. A detailed clinical care assessment and management was performed, including dietary history, physical examination, laboratory evaluation of blood ketone bodies, and results of blood gas analysis for metabolic analysis. Results The results showed that the blood ketone body was elevated, accompanied by severe metabolic acidosis and clinical symptoms of polydipsia, polyphagia and polyuria. After massive fluid replacement, small dose insulin treatment, and adjustment of diet structure, the patient's clinical symptoms disappeared, and the blood ketone body laboratory results returned to normal. Conclusions This case highlights the association between non-hyperglycemic diabetic ketoacidosis and sodium-glucose cotransporter 2 inhibitors, and emphasizes the importance of thorough medication history and blood test results for accurate diagnosis. As de novo diabetes agents become more popular worldwide, increased awareness of nonhyperglycemic diabetic ketoacidosis is critical to ensure prompt diagnosis and effective management.