How is euglycemic diabetic ketoacidosis defined?

• A. Ketogenesis with normal or mildly elevated glucose levels.
• B. Very high glucose with ketosis.
• C. No ketosis but high blood sugar.
• D. Ketone levels absent.

Answer: (A)

Euglycemic diabetic ketoacidosis describes a state where ketone production and metabolic acidosis occur even though blood glucose is normal or only mildly elevated. This happens because insulin deficiency and elevated counter-regulatory hormones drive lipolysis and hepatic ketogenesis, but factors such as glucosuria (for example, from SGLT2 inhibitors) or reduced caloric intake keep glucose levels from rising as high as in classic DKA. So the defining picture is ketogenesis with normal or mildly elevated glucose, not very high glucose with ketosis, no ketosis, or absence of ketones.