The Normal Glucose That Isn’t: Euglycemic DKA in the Emergency Department

Sunday, April 12, 2026

5:20 PM - 5:30 PM PT

Location: Cascade Ballroom II - 2nd Floor

CE: 0.25 CME Credit

Speaker(s)

Sophia Spann, DO

Medical Education Fellow
University of California Irvine Medical Center
Orange, California

Disclosure(s): No financial relationships to disclose

Disclosure(s):

Sophia Spann, DO: No financial relationships to disclose

Euglycemic diabetic ketoacidosis (EDKA) is an under recognized cause of anion gap metabolic acidosis that can be overlooked due to normal or near-normal blood glucose levels. This case based lecture reviews those at risk of EDKA, early recognition, physiologic review of the process, and treatment. Highlighted in this lecture include key diagnostic pitfalls that contribute to delayed recognition, with emphasis on avoiding reliance on glucose values alone. The session concludes with a practical overview of treatment principles, focusing on early insulin therapy with concurrent dextrose to safely resolve ketosis and acidosis.

Learning Objectives:

Identify patient populations at increased risk for euglycemic diabetic ketoacidosis, including those using SGLT2 inhibitors, pregnant patients, and individuals with prolonged fasting or acute illness.
2. Differentiate between diving-related barotrauma and inert gas disorders based on symptom onset and dive profile.
Apply evidence-based treatment principles for euglycemic diabetic ketoacidosis, including the appropriate use of insulin and early dextrose administration to resolve ketosis and metabolic acidosis.