A Case of Euglycemic Diabetic Ketoacidosis in a Patient With Type 2 Diabetes Mellitus and COVID-19.
covid 19
diabetes mellitus type 2
diabetic ketoacidosis (dka)
emergency department
euglycemic dka
medical intensive care unit
sars-cov-2
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
11 Dec 2020
11 Dec 2020
Historique:
entrez:
18
1
2021
pubmed:
19
1
2021
medline:
19
1
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 33457131
doi: 10.7759/cureus.12029
pmc: PMC7797421
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e12029Informations de copyright
Copyright © 2020, Morrison et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
N Engl J Med. 2016 Mar 17;374(11):1094
pubmed: 26981940
Acta Clin Belg. 2020 Jun 16;:1-5
pubmed: 32544373
Endocr J. 2011;58(12):1045-53
pubmed: 22033476
Clin Infect Dis. 2020 Nov 5;71(8):1937-1942
pubmed: 32301997
Diabetes. 2002 Dec;51(12):3391-9
pubmed: 12453891
Diabetol Int. 2020 Oct 28;:1-4
pubmed: 33133998
Am J Nephrol. 1997;17(1):36-41
pubmed: 9057951
Ann Intern Med. 1986 Dec;105(6):836-40
pubmed: 3096181
MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):362-365
pubmed: 29596400
Diabetes Care. 2015 Sep;38(9):1638-42
pubmed: 26294774
Diabetes Obes Metab. 2020 Oct;22(10):1935-1941
pubmed: 32314455
Diabetes Care. 2018 Sep;41(9):1839-1841
pubmed: 30135197
J Clin Endocrinol Metab. 2020 Aug 1;105(8):
pubmed: 32556147