Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus
Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2018-09-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2018/1/EDM18-0094.xml |
| _version_ | 1818963382182608896 |
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| author | Sebastian Hörber Sarah Hudak Martin Kächele Dietrich Overkamp Andreas Fritsche Hans-Ulrich Häring Andreas Peter Martin Heni |
| author_facet | Sebastian Hörber Sarah Hudak Martin Kächele Dietrich Overkamp Andreas Fritsche Hans-Ulrich Häring Andreas Peter Martin Heni |
| author_sort | Sebastian Hörber |
| collection | DOAJ |
| description | Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine. Past history revealed a paranoid schizophrenia diagnosed 10 years ago and for which the patient was treated with risperidone for many years. Acute treatment with intravenous fluids, intravenous insulin infusion and sodium bicarbonate improved the symptoms. Further laboratory investigations confirmed diagnosis of autoimmune type 1 diabetes. After normalization of blood glucose levels, the patient could soon be discharged with a subcutaneous insulin therapy. |
| first_indexed | 2024-12-20T12:44:20Z |
| format | Article |
| id | doaj.art-08ee5ac7106d4ae09cba627f42ca3571 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-20T12:44:20Z |
| publishDate | 2018-09-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-08ee5ac7106d4ae09cba627f42ca35712022-12-21T19:40:21ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732018-09-01111510.1530/EDM-18-0094Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitusSebastian Hörber0Sarah Hudak1Martin Kächele2Dietrich Overkamp3Andreas Fritsche4Hans-Ulrich Häring5Andreas Peter6Martin Heni7Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, GermanyDepartment of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Tübingen, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, GermanyDivision of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, GermanyDiabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine. Past history revealed a paranoid schizophrenia diagnosed 10 years ago and for which the patient was treated with risperidone for many years. Acute treatment with intravenous fluids, intravenous insulin infusion and sodium bicarbonate improved the symptoms. Further laboratory investigations confirmed diagnosis of autoimmune type 1 diabetes. After normalization of blood glucose levels, the patient could soon be discharged with a subcutaneous insulin therapy.https://edm.bioscientifica.com/view/journals/edm/2018/1/EDM18-0094.xml |
| spellingShingle | Sebastian Hörber Sarah Hudak Martin Kächele Dietrich Overkamp Andreas Fritsche Hans-Ulrich Häring Andreas Peter Martin Heni Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus Endocrinology, Diabetes & Metabolism Case Reports |
| title | Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| title_full | Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| title_fullStr | Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| title_full_unstemmed | Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| title_short | Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| title_sort | unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus |
| url | https://edm.bioscientifica.com/view/journals/edm/2018/1/EDM18-0094.xml |
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