Euglycemic Diabetic Ketoacidosis with Acute Pancreatitis in a Patient Not Known to Have Diabetes.
Endocr Pract. 2014 Nov 4;:1-12
Authors: Prater J, Chaiban JT
Objective: Euglycemic diabetic ketoacidosis (DKA) is a less known entity of DKA presentation. The aim of this case report is to alert the physician about the possibility of euglycemic DKA in a patient presenting with metabolic ketoacidosis and to highlight the complex physiology between severe alcohol related pancreatic injury, ketoacidosis and starvation.Methods: We present herein a patient with known history of alcoholism who presented with metabolic acidosis and acute pancreatitis and was not known to have diabetes.Results: CT scan of the abdomen showed severe pancreatitis. The patient had not been eating for more than a week. Laboratory work-up showed severe metabolic acidosis and the absence of alcohol. The acidosis improved only after euglycemic DKA was suspected and intravenous insulin infusion and dextrose was initiated and her fluid/electrolyte abnormalities and carbohydrate metabolism were restored.Conclusion: Euglycemic DKA occurs in a small subset of patients with DKA and can go undiagnosed at initial presentation. It is thought to be due to starvation and food restriction and inhibition of gluconeogenesis seen mainly in patients with previous history of diabetes and insulin deficiency.
PMID: 25370318 [PubMed - as supplied by publisher]