Low Serum Bicarbonate in a Patient With Diabetes Mellitus: A Quiz

A 55-year-old woman with a history of insulindependent diabetes mellitus was admitted for glucose for ovarian masses. Nephrology was consulted after routine morning laboratory measurements revealed a (Table 1). Inpatient medications included insulin, and acetaminophen as needed. She revealed that a few weeks prior, she was started on a sodium/glucose cotransporter 2 (SGLT2) inhibitor but that she had not taken it in more than 1 week. Her serum glucose was 232 mg/dL and serum creatinine was 1.03 mg/dL (corresponding to an 1.73 m2). Her examination was unremarkable and she was asymptomatic.

Automated summary

A 55-year-old woman with a history of insulin-dependent diabetes mellitus was admitted to the hospital for ovarian masses. Nephrology was consulted after routine morning laboratory measurements showed abnormal results. She had recently started a sodium/glucose cotransporter 2 (SGLT2) inhibitor but had stopped taking it for over a week. Her blood glucose was 232 mg/dL and serum creatinine was 1.03 mg/dL (corresponding to an estimated glomerular filtration rate of 1.73 m2). Her physical examination was normal and she did not have any symptoms.