Department of Internal Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA 19107, USA.
J Gen Intern Med. 2010 Apr;25(4):369-73. doi: 10.1007/s11606-009-1237-9. Epub 2010 Jan 30.
Diabetic ketoacidosis (DKA) has been the hallmark of a life-threatening medical emergency for poorly controlled or newly diagnosed type 1 diabetics. In the last two decades, this traditional association has been challenged with increasing reports of type 2 diabetics presenting with DKA. We report the case of a 75-year-old woman with known type 2 diabetes who presented in DKA and was found to have pancreatic adenocarcinoma. A link between diabetes mellitus and pancreatic cancer has been investigated, but the literature remains inconclusive as to whether diabetes mellitus (DM) is a cause or result of pancreatic cancer or simply the confluence of two common entities. Previous case reports of pancreatic tumors presenting with DKA all represented neuroendocrine tumors. Adenocarcinoma of the pancreas should be considered in the list of precipitants for DKA in type 2 DM.
糖尿病酮症酸中毒（DKA）一直是未得到良好控制或新诊断的 1 型糖尿病患者出现危及生命的医疗紧急情况的标志。在过去的二十年中，随着越来越多的报告显示 2 型糖尿病患者出现 DKA，这种传统的关联受到了挑战。我们报告了一例 75 岁女性，患有已知的 2 型糖尿病，出现 DKA，并被发现患有胰腺腺癌。糖尿病和胰腺癌之间存在关联，但是文献对于糖尿病是否是胰腺癌的原因或结果，或者只是两种常见实体的融合，仍然没有定论。以前报告的以 DKA 为表现的胰腺肿瘤均为神经内分泌肿瘤。在 2 型糖尿病 DKA 的诱发因素列表中应考虑胰腺腺癌。
