JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · Sep 2019
Case ReportsKetoacidosis in Euglycemic Patients With Type 2 Diabetes After Abdominal Surgery.
Diabetic ketoacidosis is defined as hyperglycemia >250 mg/dL with metabolic acidosis of arterial pH <7.3, serum bicarbonate <18 mEq/L with positive urine and serum ketones and an anion gap >10. Euglycemic ketoacidosis has been reported in patients with type 2 diabetes and in patients with type 1 diabetes. ⋯ Both patients developed altered mental status, metabolic acidosis with a bicarbonate level as low as 14 mEq/L, and an anion gap > 18, without hyperglycemia. Both patients had β-hydroxybutyrate levels > 5 mmol/L.