tetano
Editor, Senior Moderator
Cureus
. 2020 Dec 11;12(12):e12029.
doi: 10.7759/cureus.12029.
A Case of Euglycemic Diabetic Ketoacidosis in a Patient With Type 2 Diabetes Mellitus and COVID-19
Nathan Morrison[SUP] 1 [/SUP], Katherine Barnett[SUP] 1 [/SUP], Julianna Tantum[SUP] 2 [/SUP], Hannah K Morrison[SUP] 3 [/SUP], Michael Whalen[SUP] 3 [/SUP]
Affiliations
Abstract
Diabetic ketoacidosis (DKA) can cause significant morbidity and mortality in patients with type 1 or type 2 diabetes mellitus. DKA causes an approximate annual hospitalization rate of 6.3% and in-hospital case-fatality rate of 0.4%. A subset of DKA cases termed euglycemic diabetic ketoacidosis (eu-DKA) is characterized by euglycemia (<200 mg/dL), high anion gap metabolic acidosis, and an increased plasma ketone concentration. This clinical syndrome comprises approximately 2.6% to 3.2% of total DKA admissions, making it a rare condition. In this case report, a male patient was diagnosed with coronavirus disease 2019 (COVID-19) three days prior to arriving at the emergency department. Upon evaluation, he displayed severe acidemia and was diagnosed with eu-DKA. He was started on intravenous regular insulin and D5 one-half normal saline, which markedly improved his metabolic status. Notably, his admission was uncomplicated by respiratory symptoms of COVID-19. It is proposed that his eu-DKA was catalyzed by his recent COVID-19 infection. Recent studies that have shown COVID-19 may increase lipolysis and induce ketogenesis in susceptible patients.
Keywords: covid 19; diabetes mellitus type 2; diabetic ketoacidosis (dka); emergency department; euglycemic dka; medical intensive care unit; sars-cov-2.
. 2020 Dec 11;12(12):e12029.
doi: 10.7759/cureus.12029.
A Case of Euglycemic Diabetic Ketoacidosis in a Patient With Type 2 Diabetes Mellitus and COVID-19
Nathan Morrison[SUP] 1 [/SUP], Katherine Barnett[SUP] 1 [/SUP], Julianna Tantum[SUP] 2 [/SUP], Hannah K Morrison[SUP] 3 [/SUP], Michael Whalen[SUP] 3 [/SUP]
Affiliations
- PMID: 33457131
- PMCID: PMC7797421
- DOI: 10.7759/cureus.12029
Abstract
Diabetic ketoacidosis (DKA) can cause significant morbidity and mortality in patients with type 1 or type 2 diabetes mellitus. DKA causes an approximate annual hospitalization rate of 6.3% and in-hospital case-fatality rate of 0.4%. A subset of DKA cases termed euglycemic diabetic ketoacidosis (eu-DKA) is characterized by euglycemia (<200 mg/dL), high anion gap metabolic acidosis, and an increased plasma ketone concentration. This clinical syndrome comprises approximately 2.6% to 3.2% of total DKA admissions, making it a rare condition. In this case report, a male patient was diagnosed with coronavirus disease 2019 (COVID-19) three days prior to arriving at the emergency department. Upon evaluation, he displayed severe acidemia and was diagnosed with eu-DKA. He was started on intravenous regular insulin and D5 one-half normal saline, which markedly improved his metabolic status. Notably, his admission was uncomplicated by respiratory symptoms of COVID-19. It is proposed that his eu-DKA was catalyzed by his recent COVID-19 infection. Recent studies that have shown COVID-19 may increase lipolysis and induce ketogenesis in susceptible patients.
Keywords: covid 19; diabetes mellitus type 2; diabetic ketoacidosis (dka); emergency department; euglycemic dka; medical intensive care unit; sars-cov-2.