The efficacy of a 24-hour preoperative pause for SGLT2-inhibitors in type II diabetes patients undergoing bariatric surgery to mitigate euglycemic diabetic ketoacidosis

Abstract

The case emphasizes the risk of euglycemic diabetic ketoacidosis (DKA) after bariatric surgery and SGLT2 inhibitor use, highlighting the importance of patient education and healthcare provider monitoring. Potential causes include increased urinary glucose excretion from SGLT2 inhibitors, reduced carbohydrate intake post-surgery, and possible insulin discontinuation effects. The current recommendation from AACE to discontinue SGLT2 inhibitors 24 h before surgery may require additional research to determine the optimal timing of discontinuation.