Euglycemic DKA is a rare but significant complication of SGLT-2 inhibitors, characterized by ketosis with normal or mildly elevated glucose levels. This occurs due to ↓ insulin and ↑ glucagon, promoting lipolysis and ketogenesis. Look for signs like nausea, vomiting, or abdominal pain in patients on SGLT-2 inhibitors, even when glucose levels are <250 mg/dL, as early recognition and treatment are critical to avoid severe metabolic derangements. MedThreads