INS and infection: DKA is commonly associated with stress, such as that associated with infection or major surgery, in patients with type 2 DM.[8] Eu-DKA is an uncommon form of DKA that is characterized by metabolic acidosis (pH < 7.3), a decreased level of serum bicarbonate (<18 mEq/L), and a relatively low blood glucose level (<200 mg/dL).[9] The proposed mechanisms of eu-DKA induced by SGLT-2 inhibitors are as follows: SGLT-2 inhibitors reduce blood glucose levels, thereby decreasing the secretion of endogenous insulin by pancreatic β-cells.