Case report links semaglutide intolerance to euglycemic ketoacidosis at glucose 132

The wire

1. 01In the International Medical Case Reports Journal, authors describe a woman with type 2 diabetes who had three weeks of nausea, vomiting and minimal intake after starting semaglutide at 0.25 mg weekly, escalating to 0.5 mg weekly.
2. 02Labs showed glucose 132 mg/dL, venous pH 7.13, bicarbonate 9 mmol/L and anion gap 26 mmol/L; the authors argue near-normal glucose should not delay ketone and acid-base testing.
3. 03This is a single case report and the temporal association is described as clinically plausible rather than causal, with recent SGLT2 inhibitor use a confounder despite reported discontinuation.

From the source

Severe Euglycemic Diabetic Ketoacidosis After Semaglutide-Associated Poor Intake Despite Empagliflozin Discontinuation: A Case Report

International medical case reports journal · 2026 · Niknam K, Niknam T et al.