Euglycemic Diabetic Ketoacidosis A Dreaded Complication in Post-Operative Patients In ICU

Authors

  • Dr. Wasim Feroz
  • Dr. Sandeep Nale
  • Dr. H S Rawat

DOI:

https://doi.org/10.46858/vimshsj.7108

Keywords:

Euglycemic diabetic ketoacidosis, metabolic acidosis, anion gap, ketonemia, ketonuria

Abstract

Diabetic ketoacidosis (DKA) is a life threatening metabolic disorder and a known complication of Diabetes mellitus, caused by insulin deficiency or insulin resistance, which allows the catabolism of free fatty acids into ketone bodies, with high blood sugar levels. A rare variant of it is, euglycemic diabetic ketoacidosis (EKDA). We report a case of 60 year old female who was posted for Posterior lumbar interbody fusion (PLIF) and had this complication postoperatively. We believe that this case would serve as a reminder to all practitioners and intensivist to consider ketosis in a diabetic patient despite their serum glucose levels being within the normal range and all anaesthetist to consider the use of insulin during the intra op period even the blood sugar level is normal in peri operative period. This case report summarizes, in brief, the etiology, pathophysiology and treatment of EDKA.

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References

Nyenwe EA & Kitabchi AE 2016 The evolution of diabetic ketoacidosis: an update of its etiology, pathogenesis and management. Metabolism 65 507–521. (doi:10.1016/j. metabol.2015.12.007).

Laffel L 1999 Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes/Metabolism Research and Reviews 15 412–426. (doi:10.1002/(SICI)1520- 7560(199911/12)15:6<412::AID-DMRR72>3.0.CO;2-8).

Kitabchi AE, Umpierrez GE, Miles JM & Fisher JN 2009 Hyperglycemic crises in adult patients with diabetes. Diabetes Care 32 1335–1343. (doi:10.2337/dc09-9032).

Burge MR, Hardy KJ & Schade DS 1993 Short-term fasting is a mechanism for the development of euglycemic ketoacidosis during periods of insulin deficiency. Journal of Clinical Endocrinology and Metabolism 76 1192–1198. (doi:10.1210/jc.76.5.1192).

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Published

2020-03-06

How to Cite

Dr. Wasim Feroz, Dr. Sandeep Nale, & Dr. H S Rawat. (2020). Euglycemic Diabetic Ketoacidosis A Dreaded Complication in Post-Operative Patients In ICU. VIMS Health Science Journal, 7(1), 34–36. https://doi.org/10.46858/vimshsj.7108

Issue

Section

Case Report