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Cited by 139Diabetes Management and ResearchRenal function and acid-base balanceDiabetes Treatment and Management

The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.

Euglycemic diabetic ketoacidosis: a diagnostic and therapeutic dilemma

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Rawla, Prashanth, Vellipuram, Anantha R, Bandaru, Sathyajit S, Pradeep Raj, Jeffrey·2017·Endocrinology, Diabetes & Metabolism Case Reports
DOI 10.1530/edm-17-0081PMC PMC5592704
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Abstract

Summary: Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation. Both of them were aggressively treated with intravenous fluids and insulin drip as per the protocol for the blood glucose levels till the anion gap normalized, and the metabolic acidosis reversed. This case series summarizes, in brief, the etiology, pathophysiology and treatment of EDKA. Learning points: Euglycemic diabetic ketoacidosis is rare. Consider ketosis in patients with DKA even if their serum glucose levels are normal. High clinical suspicion is required to diagnose EDKA as normal blood sugar levels masquerade the underlying DKA and cause a diagnostic and therapeutic dilemma. Blood pH and blood or urine ketones should be checked in ill patients with diabetes regardless of blood glucose levels.

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Metadata

Authors
Rawla, P., Vellipuram, A. R., Bandaru, S. S., & Pradeep Raj, J.
Affiliations
  • Sovah Health Martinsville (US)
  • Texas Tech University (US)
  • Beth Israel Deaconess Medical Center (US)
  • 4Department of Pharmacology, St John’s Medical College, Bangalore, India
Corresponding author
Rawla, Prashanth
ORCID
Venue
Endocrinology, Diabetes & Metabolism Case Reports
Publisher
Bioscientifica
Published
2017-09-04
Volume
2017
ISSN
2052-0573 (ISSN-L)
DOI
10.1530/edm-17-0081
PMC
PMC5592704
OpenAlex
W2752336798
Cited by
139
References
14
Citations by year
2026: 2 · 2025: 13 · 2024: 27 · 2023: 14 · 2022: 29 · 2021: 17 · 2020: 15 · 2019: 11 · 2018: 6 · 2017: 4
FWCI
7.79
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Endocrinology Diabetes and Metabolism Case Reports (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
euglycemic diabetic ketoacidosis, diabetic ketoacidosis, anion gap metabolic acidosis, ketonuria, ketonemia, normoglycemia, starvation, urinary tract infection, intravenous insulin therapy, fluid resuscitation, diabetes mellitus

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