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Case Reports
. 2018 Oct 2:2018:bcr2018226092.
doi: 10.1136/bcr-2018-226092.

Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis

Sushant Nanavati  1 , Vinod Kumar  1 , Gabriel Melki  1 , Monisha Singhal  1
Affiliations
Case Reports

Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis

Sushant Nanavati et al. BMJ Case Rep. .

Abstract

Usually, hyperglycaemia crisis presents with acidotic pH, but ketoalkalosis is a rare and unheard entity presenting in diabetic ketoacidosis. We describe three unique cases where the patients present with hyperglycaemia >250 mg/dL, normal or alkalotic pH, and bicarbonate >20 meq/L, which does not meet criteria for diabetic ketoacidosis. However, once these patients were supplemented with intravenous fluids, diagnosis of diabetic ketoacidosis was evident in laboratory analysis. These case series provide a learning opportunity in diagnosing and management of this rare phenomenon.

Keywords: adult intensive care; diabetes; fluid electrolyte and acid-base disturbances; metabolic disorders.

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Conflict of interest statement

Competing interests: None declared.

References

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