S. Nanavati, V. Kumar, G. Melki and M. Singhal (2018). Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis. BMJ case reports, 2018. https://doi.org/10.1136/bcr-2018-226092

PubMed 30279254

[Abstract]
Usually, hyperglycaemia crisis presents with acidotic pH, but ketoalkalosis is a rare and unheard entity presenting in diabetic ketoacidosis. We describe three unique cases where the patients present with hyperglycaemia >250 mg/dL, normal or alkalotic pH, and bicarbonate >20 meq/L, which does not meet criteria for diabetic ketoacidosis. However, once these patients were supplemented with intravenous fluids, diagnosis of diabetic ketoacidosis was evident in laboratory analysis. These case series provide a learning opportunity in diagnosing and management of this rare phenomenon.