Question special
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SGLT-2 inhibitors are becoming increasingly used for both their glycaemic lowering effects and also their protective effects on the cardiovascular and renal systems. Euglycaemic ketoacidosis is a phenomenon that has been recognised with the use of this medication, particularly during times of acute infection, during the fasting state and also in the perioperative period. What is the mechanism behind the development of euglycaemic ketoacidosis? What factors should be taken into consideration when deciding if this drug is to be continued or discontinued after this complication occurs?