Background: Euglycemic diabetic ketoacidosis (EDKA) carries serious risks for mortality and morbidity for both the mother and the baby, and it is essential to recognize it early and start immediate treatment.
Case Presentation: We present a case of EDKA in a 28-week pregnant woman known to have type 1 diabetes. She was found to have severe acidosis with a blood sugar level of 10.6 mmol/L (190.8 mg/dL) and normal anion gap. She was found to have EDKA, which was confirmed later with a depressed venous pH and bicarbonate level and an increased serum ketone level. The patient's acidosis was not improving significantly with 0.05 units/kg/h of insulin infusion, so a full dose of 0.1 unit/kg/h of insulin infusion was started following a full diabetic ketoacidosis (DKA) protocol regardless of her blood sugar level. The patient showed gradual improvement and was discharged home after 4 days, with follow-up with endocrinology and obstetrics.
Conclusion: In conclusion, EDKA is a critical complication of diabetes, especially in pregnant women. Therefore, it is crucial to treat it early and potentially consider following a full DKA protocol using 0.1 unit/kg/h insulin infusion instead of 0.05 unit/kg/h.
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http://dx.doi.org/10.1002/emp2.13089 | DOI Listing |
Medicine (Baltimore)
January 2025
The Department of Clinical Laboratory, Zhejiang Hospital, Hangzhou, China.
Rationale: Gitelman syndrome (GS) is a rare hereditary electrolyte disorder caused by mutations in the SLC12A3 gene. There is limited literature on the role of hydrochlorothiazide (HCT) testing and the SLC12A3 single heterozygous mutation in the diagnosis and management of patients with GS. In addition, cases of GS with concomitant kidney stones are rare.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
The management of type 1 diabetes in pregnancy with new technologies is challenging. Sometimes the complexity of new-generation systems such as "continuous subcutaneous insulin infusion, CSII" and patient or provider preference do not allow their use, so women with type 1 diabetes in pregnancy continue to be treated with subcutaneous multiple-injection insulin therapy using pens. Smart insulin pens are new tools that allow for data collection on insulin dose and time of administration and have additional connectivity features.
View Article and Find Full Text PDFCureus
December 2024
Medical School, Edward Via College of Osteopathic Medicine, Auburn, USA.
Diabetic ketoacidosis (DKA), hypertriglyceridemia, and acute pancreatitis are a rare and potentially fatal triad. This article presents a fatal case of acute pancreatitis, DKA, and hypertriglyceridemia in a patient with undiagnosed diabetes mellitus struggling with alcoholism. The patient was unresponsive to standard pancreatitis and DKA treatment protocol and progressed to develop multi-organ failure.
View Article and Find Full Text PDFEndocrinol Diabetes Metab Case Rep
January 2025
Summary: Palmoplantar keratoderma (PPK), characterised by excessive epidermal thickening of the skin on the palms and/or plantar surfaces of the feet, can be hereditary or acquired. Here, we report a case of a 53-year-old woman with a history of sub-optimally controlled diabetes mellitus presenting with fevers and decreased Glasgow Coma Scale (GCS) to a tertiary hospital. She was diagnosed with diabetic ketoacidosis (DKA), with blood glucose at 40 mmol/L and ketones at 7 mmol/L, in the setting of a methicillin-sensitive Staphylococcus aureus necrotising soft tissue back infection.
View Article and Find Full Text PDFPediatr Crit Care Med
January 2025
Division of Medical Critical Care, Department of Pediatrics, Boston Children's Hospital, Boston, MA.
Objectives: To assess factors associated with serum phosphorus (P) and hypophosphatemia in children with type 1 diabetes mellitus (T1DM) treated for diabetic ketoacidosis (DKA).
Design: Retrospective cohort.
Setting: Community-based PICU in a university-affiliated hospital.
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