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Metabolic Acidosis in Postsurgical Patient on Canagliflozin and Metformin

A Case Report

Darwish, Ahmed M., MD

doi: 10.1213/XAA.0000000000000888
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Canagliflozin is a novel drug for diabetes mellitus with the mechanisms of inducing glucosuria through inhibition of the sodium-glucose cotransporter 2 in the kidney independent of insulin activity. We are reporting euglycemic ketoacidosis with severe life-threatening metabolic acidosis. The 2 patients described had type 2 diabetes mellitus and were in a state of relative starvation after abdominal surgery. The first patient had been given an oral diet but was restricted with regard to calorie and sugar intake. The second patient had been nil per os since the operation.

From the Department of Anesthesiology and Critical Care, University of Southern California, Los Angeles, California.

Accepted for publication August 8, 2018.

Funding: None.

The author declares no conflicts of interest.

Address correspondence to Ahmed M. Darwish, MD, Department of Anesthesiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033. Address e-mail to ahmeddarwish@hotmail.com.

© 2019 International Anesthesia Research Society
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