In contrast to the previously reported cases, this is the first documented case of a patient with type 2 diabetes who was taking an SGLT2 inhibitor and developed DKA where thyrotoxicosis associated with painless thyroiditis, which remained mild and did not escalate to thyroid crisis, may have contributed as a possible trigger in the presence of other precipitating factors. This evidence concerns the gene SLC5A2 and thyroiditis.