Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May;8(2):111-114.
doi: 10.5811/cpcem.1389.

Diabetic Ketoalkalosis: A Case Report

April Brill  1 , Nirav Chheda  1 , Daniel Strama  2 , Ramesh Soundararajan  1
Affiliations

Diabetic Ketoalkalosis: A Case Report

April Brill et al. Clin Pract Cases Emerg Med. 2024 May.

Abstract

Introduction: Diabetic ketoacidosis (DKA) is a common diagnosis in the emergency department (ED). However, one must consider other causes for acid-base disturbances when the pattern is not consistent with typical presentation.

Case report: A 52-year-old female with a history of insulin-dependent diabetes mellitus type 2 presented to the ED with abdominal pain, nausea, and vomiting for three days. Her diagnostic workup revealed diabetic ketoacidosis but with concurrent metabolic alkalosis. Standard treatment for DKA was initiated, and there was improvement of her mentation and resolution of metabolic derangements.

Conclusion: Overlooking a diagnosis of DKA because of alkalosis on venous blood gas testing could lead to inappropriate treatment and, therefore, increased risk of morbidity and mortality in the affected patient.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

References

    1. Centers for Disease Control and Prevention . National diabetes statistics report 2020: estimates of diabetes and its burden in the United States. Available at: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-stat.... Accessed May 8, 2023.
    1. Nanavati S, Kumar V, Melki G, et al. . Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis. BMJ Case Reports. 2018;2018:bcr2018226092. - PMC - PubMed
    1. Yasuda K, Hayashi M, Murayama M, et al. . Acidosis-induced hypochloremic alkalosis in diabetic ketoacidosis confirmed by the modified base excess method. J Clin Endocrinol Metab. 2016;101(6):2390–5. - PubMed
    1. Funk GC, Zauner C, Bauer E, et al. . Compensatory hypochloraemic alkalosis in diabetic ketoacidosis. Diabetologia. 2003;46(6):871–3. - PubMed
    1. Bayat M, Møller N. Diabetisk ketoacidose maskeret af metabolisk alkalose [Diabetic ketoacidosis masked by metabolic alkalosis]. Ugeskr Laeger. 2013;175(46):2800–1. - PubMed