Tirzepatide

A patient with diabetes developed euglycaemic diabetic ketoacidosis (EDKA) despite treatment with tirzepatide, indicating a potential lack of efficacy of the drug in preventing this complication. The patient, who was receiving tirzepatide monotherapy [*age, sex, dosage, route, duration not stated*], presented with nausea, vomiting and abdominal pain. Laboratory investigations demonstrated a severe anion gap metabolic acidosis (CO₂ 7 mmol/L, anion gap 28, pH 7.1) and ketonuria, with only mild hyperglycaemia (glucose 167 mg/dL). There was no concurrent use of sodium-glucose cotransporter-2 inhibitors. The patient was treated with intravenous fluids, dextrose and insulin infusion according to standard diabetic ketoacidosis protocols, which led to resolution of the anion gap. …