Brill April, Chheda Nirav, Strama Daniel, Soundararajan Ramesh
Franciscan Health Olympia Fields, Emergency Department, Olympia Fields, Illinois.
Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, Illinois.
Clin Pract Cases Emerg Med. 2024 May;8(2):111-114. doi: 10.5811/cpcem.1389.
Diabetic ketoacidosis (DKA) is a common diagnosis in the emergency department (ED). However, one must consider other causes for acid-base disturbances when the pattern is not consistent with typical presentation.
A 52-year-old female with a history of insulin-dependent diabetes mellitus type 2 presented to the ED with abdominal pain, nausea, and vomiting for three days. Her diagnostic workup revealed diabetic ketoacidosis but with concurrent metabolic alkalosis. Standard treatment for DKA was initiated, and there was improvement of her mentation and resolution of metabolic derangements.
Overlooking a diagnosis of DKA because of alkalosis on venous blood gas testing could lead to inappropriate treatment and, therefore, increased risk of morbidity and mortality in the affected patient.
糖尿病酮症酸中毒（DKA）是急诊科常见的诊断。然而，当酸碱紊乱模式与典型表现不一致时，必须考虑其他病因。
一名52岁的2型胰岛素依赖型糖尿病女性因腹痛、恶心和呕吐三天就诊于急诊科。她的诊断检查显示为糖尿病酮症酸中毒，但同时伴有代谢性碱中毒。开始了DKA的标准治疗，她的精神状态有所改善，代谢紊乱也得到了解决。
由于静脉血气检测显示碱中毒而忽略DKA的诊断可能导致治疗不当，从而增加患者的发病和死亡风险。
