A 45 year old IDDM presents with abdominal pain, nausea, and dyspnea. He appears markedly tachypneic from the door. "Easy!" you think. "This is a SLAM DUNK case of DKA!" Your nurse then informs you that the patient's point of care glucose is 182...

A new class of medications for the management of diabetes (SGLT-2 inhibitors) is challenging our traditional notions of the diagnosis of diabetic ketoacidosis (DKA). Read on for quick pearls on when to suspect so called "euglycemic DKA" in the ED.