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Mixed acid-base abnormalities in diabetes.

G Sanders, G Boyle, S Hunter

    Diabetes Care
    |November 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    Diabetic ketosis typically causes acidosis, but this case study shows alkalosis. Severe vomiting and dehydration are key factors, with potassium and chloride replacement being crucial for treatment.

    Area of Science:

    • Endocrinology
    • Nephrology
    • Internal Medicine

    Background:

    • Diabetic ketosis is a serious complication of diabetes mellitus.
    • It is typically characterized by metabolic acidosis.
    • This condition requires prompt medical intervention.

    Observation:

    • A patient presented with diabetic ketosis accompanied by metabolic alkalosis, a rare presentation.
    • Precipitating factors included severe vomiting leading to ion loss (hydrogen, potassium, chloride) and dehydration.
    • Alkali ingestion was also considered a potential contributing factor.

    Findings:

    • The patient's mixed acid-base disturbance was primarily treated with potassium and chloride replacement.
    • Unlike previous cases treated with high-dose insulin, this patient received limited insulin (20 U).

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  • The limited insulin therapy led to a near-complete reversal of the metabolic abnormality within 12 hours.

    • Implications:

    • This case highlights the importance of considering metabolic alkalosis in diabetic ketosis, especially with severe vomiting.
    • Limited insulin dosing may be effective in managing this specific mixed acid-base disturbance.
    • Further research into the mechanisms and optimal treatment of this rare syndrome is warranted.