This case report describes a 51-year-old man, who had Type 2 diabetes and was being treated with a sodium-glucose-cotransporter 2 inhibitor (SGLT2i). The patient developed euglycaemic diabetic ketoacidosis (DKA) during surgery. A perioperative arterial blood gas analysis revealed meta-bolic acidosis (pH = 7.07), but the euglycaemic component of the DKA resulted in a delayed diagnosis of the DKA by 12 hours. A delayed diagnosis of DKA can be fatal, thus em-phasising the importance of considering DKA as a dif-erential diagnosis in SGLT2i-treated patients with unspecific symp-toms.
