Unexpected cause of recurrent diabetic ketoacidosis in type 1 diabetes: a case report.

Cannabinoid hyperemesis syndrome Cannabis Diabetic ketoacidosis Type 1 diabetes

Journal

BMC endocrine disorders
ISSN: 1472-6823
Titre abrégé: BMC Endocr Disord
Pays: England
ID NLM: 101088676

Informations de publication

Date de publication:
03 Jul 2023
Historique:
received: 01 11 2022
accepted: 28 06 2023
medline: 5 7 2023
pubmed: 4 7 2023
entrez: 3 7 2023
Statut: epublish

Résumé

Gastrointestinal (GI) symptoms are commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, GI symptoms can persist after DKA resolves, which can pose diagnostic and management challenges for physicians, especially when dealing with an exceptional diagnosis such as cannabinoid hyperemesis syndrome (CHS). In this case report, we present a patient with type 1 diabetes who had been treated for DKA 6 times in the past year and was eventually diagnosed with CHS. In conclusion, this case demonstrates that a presumptive and incorrect diagnosis can mislead physicians, especially when dealing with challenging diagnoses. Therefore, patients with type 1 diabetes with unusual presentations, such as unexpectedly high pH and bicarbonate levels, with hyperglycemic ketosis should be screened for illicit drug use, especially cannabis.

Sections du résumé

BACKGROUND BACKGROUND
Gastrointestinal (GI) symptoms are commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, GI symptoms can persist after DKA resolves, which can pose diagnostic and management challenges for physicians, especially when dealing with an exceptional diagnosis such as cannabinoid hyperemesis syndrome (CHS).
CASE PRESENTATION METHODS
In this case report, we present a patient with type 1 diabetes who had been treated for DKA 6 times in the past year and was eventually diagnosed with CHS.
CONCLUSION CONCLUSIONS
In conclusion, this case demonstrates that a presumptive and incorrect diagnosis can mislead physicians, especially when dealing with challenging diagnoses. Therefore, patients with type 1 diabetes with unusual presentations, such as unexpectedly high pH and bicarbonate levels, with hyperglycemic ketosis should be screened for illicit drug use, especially cannabis.

Identifiants

pubmed: 37400799
doi: 10.1186/s12902-023-01394-3
pii: 10.1186/s12902-023-01394-3
pmc: PMC10316585
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

137

Informations de copyright

© 2023. The Author(s).

Références

BMJ. 2019 Jul 19;366:l4336
pubmed: 31324702
Ann Saudi Med. 2018 Sep-Oct;38(5):319-325
pubmed: 30284986
Am J Med. 2016 Aug;129(8):e139-40
pubmed: 27012856
Neurogastroenterol Motil. 2018 Sep;30(9):e13370
pubmed: 29745439
J Addict. 2019 Jan 1;2019:1307345
pubmed: 30723570
JAMA Intern Med. 2019 Jan 1;179(1):115-118
pubmed: 30398521
Diabetes Care. 2020 Jan;43(1):247-249
pubmed: 31628116

Auteurs

Rabia Khalid Alduraibi (RK)

Department of Endocrine and Diabetes, King Fahad Specialist Hospital, Box 3499, Buraydah, 52385 - 669 , Saudi Arabia. Ralduraibi@gmail.com.

Yosef Fahad Altowayan (YF)

Department of Internal Medicine, King Fahad Specialist Hospital, Buraydah, Saudi Arabia.

Bader Tha'ar AlMharwal (BT)

Department of Endocrine and Diabetes, King Fahad Specialist Hospital, Box 3499, Buraydah, 52385 - 669 , Saudi Arabia.

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