• BMJ case reports · Oct 2018

    Case Reports

    Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis.

    • Sushant Nanavati, Vinod Kumar, Gabriel Melki, and Monisha Singhal.
    • Department of Internal Medicine, St Joseph's University Medical Center, Paterson, New Jersey, USA.
    • BMJ Case Rep. 2018 Oct 2; 2018.

    AbstractUsually, 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.© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.

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