Background: 
Euglycemic Diabetic Ketoacidosis (EuDKA) can occur, especially in type 1 Diabetics and Diabetic parturients, and often has a delay in recognition and management resulting in increased adverse outcomes in these groups of patients.

Case report: 
We report a case of EuDKA, precipitated by intra-abdominal sepsis and poor oral intake with omission of insulin in a patient with type 2 Diabetes mellitus, who had a Total Abdominal Hysterectomy 3 days previously. She was successfully treated with hydration, intravenous insulin infusion and antibiotics appropriate for the sepsis before being discharged home uneventfully.

Discussion: 
The diagnosis of EuDKA is not usually suspected in the absence of hyperglycaemia, defined as serum glucose concentration more than 13.9 mmol/L (250mg/dL), but needs to be urgently managed as an emergency. EuDKA may occur post-operatively if basal insulin is omitted when there is normoglycaemia despite poor oral intake. This absence of hyperglycaemia may mask the diagnosis and delay the management leading to significant morbidity. Currently there is a paucity of reports of EuDKA in the post-operative period. Our report hopes to bring up awareness of this clinical condition to expedite management and prevent mobidity. 


06 / Euglycemic diabetic ketoacidosis in a Patient who had total hysterectomy.