Uncontrolled diabetes with a hemoglobin A1c above 11%, chronic and severe active foot ulceration/osteomyelitis, and dietary calorie restrictions during the inpatient setting may have contributed to the “perfect storm.” Unfortunately, there are currently no guidelines from endocrinology or internal medicine societies regarding the management of SGLT2 inhibitor-induced euglycemic DKA. The gene discussed is SLC5A2; the disease is diabetes mellitus.