Diabetic Ketoacidosis in a Patient With Type 2 Diabetes Following Ophthalmic Steroid Use: A Rare Etiology

The systemic adverse effects of corticosteroids are well established. However, steroid-induced diabetic ketoacidosis (DKA) has been rarely reported, and hyperglycemia resulting from topical ophthalmic corticosteroids remains insufficiently described, despite their widespread use and perceived safety. We report the case of a 70-year-old female patient with longstanding type 2 diabetes mellitus who presented with DKA following the postoperative use of topical steroid eyedrops. The condition resolved within 24 hours with appropriate management, including isotonic fluid resuscitation, intravenous insulin infusion, and electrolyte replacement. Secondary causes of DKA were excluded through a thorough evaluation and multidisciplinary cooperation. This case provides clinical evidence of the systemic metabolic effects of ophthalmic corticosteroids, particularly in patients with poor glycemic control. It highlights the importance of interdisciplinary communication and underscores the need for further studies to better define the risk of topical corticosteroids on glycemic control.