Diabetic ketoacidosis (DKA) is a life threatening metabolic disorder and a known complication of Diabetes mellitus, caused by insulin deficiency or insulin resistance, which allows the catabolism of free fatty acids into ketone bodies, with high blood sugar levels. A rare variant of it is, euglycemic diabetic ketoacidosis (EKDA). We report a case of 60 year old female who was posted for Posterior lumbar interbody fusion (PLIF) and had this complication postoperatively. We believe that this case would serve as a reminder to all practitioners and intensivist to consider ketosis in a diabetic patient despite their serum glucose levels being within the normal range and all anaesthetist to consider the use of insulin during the intra op period even the blood sugar level is normal in peri operative period. This case report summarizes, in brief, the etiology, pathophysiology and treatment of EDKA.
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