Related Experiment Video
Updated: Jul 14, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Euglycemic Diabetic Ketoacidosis in a Patient with Cocaine Intoxication
Asma Abu-Abed Abdin1, Muhammad Hamza2, Muhammad S Khan3
1Jordan University for Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
Abstract:
Diabetic ketoacidosis (DKA) is characterized by elevated anion gap metabolic acidosis, hyperglycemia, and elevated ketones in urine and blood. Hyperglycemia is a key component of DKA; however, a subset of DKA patients can present with near-normal blood glucose, an entity described as "euglycemic DKA." This rare phenomenon is thought to be due to starvation and food restriction in insulin dependent diabetic patients. Cocaine abuse is considered a trigger for development of DKA. Cocaine also has anorexic effects. We describe an interesting case of euglycemic DKA in a middle-aged diabetic female presenting with elevated anion gap metabolic acidosis, with near-normal blood glucose, in the settings of noncompliance to insulin and cocaine abuse. We have postulated that cocaine abuse was implicated in the pathophysiology of euglycemic DKA in this case. This case highlights complex physiological interplay between type-1 diabetes, noncompliance to insulin, and cocaine abuse leading to DKA, with starvation physiology causing development of euglycemic DKA.
Related Concept Videos
Hypoglycemia and Glucagon
Hypoglycemia
Hyperglycemia
Hyperosmolar Hyperglycemic State
Diabetic Ketoacidosis l: Introduction
Diabetic Ketoacidosis ll: Pathophysiology

