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Study · Not a test of the peptide alone · 2025

2 results

Severe euglycemic ketoacidosis following combined therapy with GLP-1 receptor agonist and SGLT-2 inhibitor, refractory to standard treatment: a case report.

Gandecka-Pempera A, Naskręt D, Adamska A, Zozulińska-Ziółkiewicz D

Frontiers in endocrinology7 Oct 2025Cited by 2 (Europe PMC)

PMID41127515 (opens in a new tab)PMCIDPMC12537370 (opens in a new tab)DOI10.3389/fendo.2025.1649270 (opens in a new tab)PepBankPUB-41127515
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Summary

BackgroundEuglycemic diabetic ketoacidosis (euDKA) is a rare but potentially life-threatening complication of diabetes, increasingly linked to SGLT-2 inhibitors (SGLT-2i) and, less frequently, GLP-1 receptor agonists (GLP-1 RA), especially in combination.Case presentationWe present the case of a 36-year-old man with newly diagnosed type 2 diabetes who developed severe euDKA within days of starting combined therapy with semaglutide and dapagliflozin. Despite prior patient education and adherence to antidiabetic therapy, persistent vomiting and carbohydrate deficiency-likely related to GLP-1 RA side effects-led to decreased insulin administration and metabolic decompensation. This case was characterized by very early onset after initiation of therapy, absence of infection or other common triggers, and resistance to standard treatment with insulin, glucose, and fluid resuscitation. Intensive care with continuous veno-venous hemodiafiltration was required, resulting in full recovery.ConclusionThis case emphasizes the potential severity of euDKA induced by GLP-1 RA and SGLT-2i combination therapy and highlights the risk of treatment resistance. The decision to initiate SGLT2i and GLP-1RA concurrently should be individualized or possibly spread apart in time, weighing the potential therapeutic benefits against the risk of rare but severe complication such as euDKA. Comprehensive education on ketone monitoring and insulin administration during intercurrent illness are essential to prevent this rare but serious complication.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study2

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone2

In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Semaglutide.

  1. 01HumanNot a test of Semaglutide aloneCase report or seriesSafety outcome

    In a 36-year-old man with new type 2 diabetes, severe euglycemic ketoacidosis developed within days of starting combined semaglutide and dapagliflozin.

    In plain wordsIn one man with new type 2 diabetes, severe ketoacidosis began within days of starting semaglutide together with dapagliflozin.

    Peptide
    Semaglutide
    Outcome
    Not applicableSevere euglycemic diabetic ketoacidosis
    Study

    n = 1

    Outcome group
    Adverse events · Metabolic and weight

    Source sentences

    Summary
    We present the case of a 36-year-old man with newly diagnosed type 2 diabetes who developed severe euDKA within days of starting combined therapy with semaglutide and dapagliflozin.

    In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.

  2. 02HumanNot a test of Semaglutide aloneCase report or seriesSafety outcome

    In this patient on combined semaglutide and dapagliflozin, ketoacidosis resisted insulin, glucose and fluids, needed hemodiafiltration in intensive care, and ended in full recovery.

    In plain wordsIn this one patient on semaglutide with dapagliflozin, ketoacidosis did not respond to standard care. He needed intensive care and recovered fully.

    Peptide
    Semaglutide
    Outcome
    Not applicableResistance to standard treatment and need for intensive care
    Study

    n = 1

    Outcome group
    Adverse events · Metabolic and weight

    Source sentences

    Summary
    This case was characterized by very early onset after initiation of therapy, absence of infection or other common triggers, and resistance to standard treatment with insulin, glucose, and fluid resuscitation. Intensive care with continuous veno-venous hemodiafiltration was required, resulting in full recovery.
    1 context sentence
    Summary · context
    We present the case of a 36-year-old man with newly diagnosed type 2 diabetes who developed severe euDKA within days of starting combined therapy with semaglutide and dapagliflozin.

    In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    11 Oct 2026, 00:04 UTC

    Study results updated

  2. Version 1

    9 Oct 2026, 03:06 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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