Villegas Katrina J, Guerrero Laura, Moussa Hala, Rajab Islam, Rezkalla Abraam, Patel Dhruv, Qarqash Mohammed A
Department of Internal Medicine, St. Joseph's University Medical Center, Paterson, NJ.
Department of Psychiatry, Bergen New Bridge Medical Center, Paramus, NJ.
Oxf Med Case Reports. 2025 Jun 27;2025(6):omaf057. doi: 10.1093/omcr/omaf057. eCollection 2025 Jun.
Euglycemic diabetic ketoacidosis is a rare form of DKA characterized by severe ketosis and metabolic acidosis without marked hyperglycemia. We report a 45-year-old female with insulin-dependent diabetes and chronic kidney disease, initially presenting with acute heart failure, who later developed euglycemic DKA. Despite near-normal glucose levels, high anion gap metabolic acidosis with significant ketones highlighted this crisis. Treatment included fluids, insulin with dextrose, and intensive monitoring. This case underscores the need for early recognition of euglycemic DKA, especially in complex patients, to improve outcomes.
正常血糖性糖尿病酮症酸中毒是糖尿病酮症酸中毒的一种罕见形式，其特征为严重酮症和代谢性酸中毒，而无明显高血糖。我们报告一例45岁女性，患有胰岛素依赖型糖尿病和慢性肾脏病，最初表现为急性心力衰竭，后来发展为正常血糖性糖尿病酮症酸中毒。尽管血糖水平接近正常，但高阴离子间隙代谢性酸中毒伴大量酮体突出了这一危急情况。治疗包括补液、加葡萄糖的胰岛素治疗以及强化监测。该病例强调了早期识别正常血糖性糖尿病酮症酸中毒的必要性，尤其是在复杂患者中，以改善预后。
