Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
-
Veysel Nijat Baş
,
Salih Uytun
Abstract
Real euglycemic diabetic ketoacidosis [DKA; blood glucose <200 mg/dL (11.1 mmol/L)] is rare, and long-lasting starvation conditions due to intervening diseases in type 1 diabetes mellitus patients may also cause it. Euglycemic DKA is also reported in insulin-dependent diabetics with depression, alcoholics, glycogen storage diseases, and chronic liver disease apart from pregnant cases. This case report is presented to emphasize the importance of evaluation of acid-base state, urine glucose, and ketone values at the application in all newly diagnosed type 1 diabetic patients with normal glucose levels by defining euglycemic DKA that resulted from long-lasting starvation during Ramadan fasting in a newly diagnosed 14-year-old male patient.
References
1. Itabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care 2006;29:2739–48.10.2337/dc06-9916Search in Google Scholar PubMed
2. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents: a consensus statement from the American Diabetes Association. Diabetes Care 2006;29:1150–9.10.2337/dc06-9909Search in Google Scholar
3. Wolfsdorf J, Craig ME, Daneman D, Dunger D, Edge J, et al. Diabetic ketoacidosis in children and adolescents with diabetes. Pediatr Diabetes 2009;10:118–33.10.1111/j.1399-5448.2009.00569.xSearch in Google Scholar PubMed
4. Jenkins D, Close CF, Krentz AJ, Nattrass M, Wright AD. Euglycaemic diabetic ketoacidosis: does it exist? Acta Diabetol 1993;30:251–3.10.1007/BF00569937Search in Google Scholar PubMed
5. Davies RG, De P, Child DF, Gemmell L, Rincon C. Euglycaemic diabetic ketoacidosis. Hosp Med 2003;64:557–8.10.12968/hosp.2003.64.9.2252Search in Google Scholar PubMed
6. McNulty SJ, English PJ. Euglycaemic diabetic ketoacidosis. Pract Diabetes Int 2002;19:63.10.1002/pdi.329Search in Google Scholar
7. Chico M, Levine SN, Lewis DF. Normoglycemic diabetic ketoacidosis in pregnancy. J Perinatol 2008;28:310–2.10.1038/sj.jp.7211921Search in Google Scholar PubMed
8. Tomihira M, Kawasaki E, Nakajima H, Imamura Y, Sato Y, et al. Intermittent and recurrent hepatomegaly due to glycogen storage in a patient with type 1 diabetes: genetic analysis of the liver glycogen phosphorylase gene (PYGL). Diabetes Res Clin Pract 2004;65:175–82.10.1016/j.diabres.2003.12.004Search in Google Scholar PubMed
9. Franke B, Carr D, Hatem MH. A case of euglycaemic diabetic ketoacidosis in pregnancy. Diabet Med 2001;18:858–9.10.1046/j.1464-5491.2001.00558.xSearch in Google Scholar PubMed
10. Munro JF, Campbell IW, McCuish AC, Duncan LJP. Euglycemic ketoacidosis. Br Med J 1973;2:578–80.10.1136/bmj.2.5866.578Search in Google Scholar PubMed PubMed Central
11. Akbay S, Yel A, Yıldırımer Ü, Can Ş, Dündar B. Diabetic ketoacidosis presenting with pseudonormoglycemia in a 15-year-old girl with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol 2013;5:133–5.10.4274/Jcrpe.905Search in Google Scholar PubMed PubMed Central
12. Derinöz O, Baş VN, Bakırtaş A. Salicylate intoxication mimicking diabetic ketoacidosis: case report. J Ankara Univ Faculty Med 2008;6:29–31.Search in Google Scholar
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Highlight: Diabetes
- Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
- Maturity-onset diabetes of the young (MODY): an update
- Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
- How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
- Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
- Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
- An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years
- Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study
- Assessment of human cartilage glycoprotein 39 (YKL-40), preptin, and nitric oxide in adolescent patients with type 1 diabetes and its relation to cardiorenal affection
- The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys
- From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma
- Three years of liraglutide treatment offers continuously optimal glycemic control in a pediatric patient with maturity-onset diabetes of the young type 3
- Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
- Transient neonatal hyperinsulinism with adaptation disorders: a report of three cases
- Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
- Alternating hypoglycemia and hyperglycemia in a toddler with a homozygous p.R1419H ABCC8 mutation: an unusual clinical picture
- Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
- Images in pediatric endocrinology
- Benefit of testosterone in pediatric genital trauma
- Original articles
- Attenuated salivary cortisol response after exercise test in children with asthma
- Reliability of pubertal maturation self-assessment in a school-based survey
- Detection of inborn errors of metabolism using GC-MS: over 3 years of experience in southern China
- Assessing biological maturity: chronological age and the pubertal development scale predict free testosterone in adolescent males
- Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls
- Longitudinal changes in C-reactive protein, proform of eosinophil major basic protein, and pregnancy-associated plasma protein-A during weight changes in obese children
- Caries in adolescents in relation to their skeletal status
- Endothelial and metabolic disorders in adolescence: low birth weight is not an isolated risk factor
- Comparison of cortisol samples in the first two weeks of life in preterm infants
- Mutations in BTD gene causing biotinidase deficiency: a regional report
- Patient reports
- Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention
- Hepatoblastoma presenting as precocious puberty: a case report
- Three cases of Wolfram syndrome with different clinical aspects
- L-asparaginase induced hypoglycemia in a case of acute lymphoblastic leukemia: a patient report
- Pyogenic granuloma, an unusual presentation of peripubertal vaginal bleeding. Case report and review of the literature
- Octreotide-associated cholestasis and hepatitis in an infant with congenital hyperinsulinism
- Two novel mutations in the homogentisate-1,2-dioxygenase gene identified in Chinese Han Child with Alkaptonuria
- Pituitary abscess in an adolescent girl: a case report and review of the literature
- Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature
- Consumptive hypothyroidism associated with parotid infantile hemangioma
- Novel mutations in the SLC25A13 gene in a patient with NICCD and severe manifestations
- Short communications
- Tetrahydrobiopterin deficiency among Serbian patients presenting with hyperphenylalaninemia
Articles in the same Issue
- Frontmatter
- Highlight: Diabetes
- Diabetes mellitus in children and adolescents – a global epidemic which has become neglected
- Maturity-onset diabetes of the young (MODY): an update
- Relationship of plasma level of chemerin and vaspin to early atherosclerotic changes and cardiac autonomic neuropathy in adolescent type 1 diabetic patients
- How does autoimmune thyroiditis in children with type 1 diabetes mellitus influence glycemic control, lipid profile and thyroid volume?
- Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood
- Evaluation of fetuin-A and carotid intima-media thickness in adolescent type 1 diabetic patients
- An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years
- Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study
- Assessment of human cartilage glycoprotein 39 (YKL-40), preptin, and nitric oxide in adolescent patients with type 1 diabetes and its relation to cardiorenal affection
- The effect of a home-based strength training program on type 2 diabetes risk in obese Latino boys
- From cerebral salt wasting to diabetes insipidus with adipsia: case report of a child with craniopharyngioma
- Three years of liraglutide treatment offers continuously optimal glycemic control in a pediatric patient with maturity-onset diabetes of the young type 3
- Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting
- Transient neonatal hyperinsulinism with adaptation disorders: a report of three cases
- Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
- Alternating hypoglycemia and hyperglycemia in a toddler with a homozygous p.R1419H ABCC8 mutation: an unusual clinical picture
- Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
- Images in pediatric endocrinology
- Benefit of testosterone in pediatric genital trauma
- Original articles
- Attenuated salivary cortisol response after exercise test in children with asthma
- Reliability of pubertal maturation self-assessment in a school-based survey
- Detection of inborn errors of metabolism using GC-MS: over 3 years of experience in southern China
- Assessing biological maturity: chronological age and the pubertal development scale predict free testosterone in adolescent males
- Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls
- Longitudinal changes in C-reactive protein, proform of eosinophil major basic protein, and pregnancy-associated plasma protein-A during weight changes in obese children
- Caries in adolescents in relation to their skeletal status
- Endothelial and metabolic disorders in adolescence: low birth weight is not an isolated risk factor
- Comparison of cortisol samples in the first two weeks of life in preterm infants
- Mutations in BTD gene causing biotinidase deficiency: a regional report
- Patient reports
- Late-onset hypercalcemia in Williams-Beuren syndrome: importance of early and frequent screening and intervention
- Hepatoblastoma presenting as precocious puberty: a case report
- Three cases of Wolfram syndrome with different clinical aspects
- L-asparaginase induced hypoglycemia in a case of acute lymphoblastic leukemia: a patient report
- Pyogenic granuloma, an unusual presentation of peripubertal vaginal bleeding. Case report and review of the literature
- Octreotide-associated cholestasis and hepatitis in an infant with congenital hyperinsulinism
- Two novel mutations in the homogentisate-1,2-dioxygenase gene identified in Chinese Han Child with Alkaptonuria
- Pituitary abscess in an adolescent girl: a case report and review of the literature
- Neonatal thyrotoxicosis with severe supraventricular tachycardia: case report and review of the literature
- Consumptive hypothyroidism associated with parotid infantile hemangioma
- Novel mutations in the SLC25A13 gene in a patient with NICCD and severe manifestations
- Short communications
- Tetrahydrobiopterin deficiency among Serbian patients presenting with hyperphenylalaninemia
