Department of Pediatrics, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
J Pediatr Endocrinol Metab. 2022 Jul 13;35(10):1316-1318. doi: 10.1515/jpem-2022-0115. Print 2022 Oct 26.
Diabetic ketoacidosis is a common emergency in type 1 diabetes mellitus patients. But rarely, they may present with alkalemia instead of acidosis. Diabetic ketoalkalosis which has been reported in adults can also be present in children with type 1 DM. The usual factors causing alkalemia were not found in our patients. This entity may manifest in both newly diagnosed and treated patients.
The first patient, an 8 year male presented with features of DKA, was diagnosed for the first time as type 1 DM, but was found to have alkalemia. The second patient, a 7 year female was a known case of Type 1 DM on insulin, who presented with dehydration and alkalemia. Both were treated with hydration and insulin and made complete recovery.
A normal or alkalotic pH does not essentially eliminate DKA and needs to be evaluated further to identify the underlying acid-base disturbance.
糖尿病酮症酸中毒是 1 型糖尿病患者常见的急症。但很少见，他们可能表现为碱中毒而不是酸中毒。已在成人中报道的糖尿病酮症碱中毒也可能存在于 1 型 DM 儿童中。在我们的患者中未发现导致碱中毒的常见因素。这种情况可能在新诊断和治疗的患者中都有表现。
第一个患者是一位 8 岁男性，表现出 DKA 的特征，首次被诊断为 1 型糖尿病，但发现有碱中毒。第二个患者是一位 7 岁女性，患有胰岛素依赖的 1 型糖尿病，她因脱水和碱中毒就诊。两人均接受补液和胰岛素治疗后完全康复。
正常或碱中毒 pH 值不一定排除 DKA，需要进一步评估以确定潜在的酸碱紊乱。
