Title: Hypernatremia in a Case of Type I Diabetes Presenting as Diabetic Ketoacidosis- Case Report

Authors: Shashikantha, Sindhu B. R., Yash Khanvilkar, Ranjitha Raj

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.61

Abstract

Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in patients with Type I Diabetes (T1DM).A hyperosmolar state also presents in patients presenting as DKA due to increased glucose production and limited glucose utilisation. A hyperglycaemic state will lead to hyponatremia due to osmotic diuresis. Although mild hypernatremia could be present in patients who also exhibit as severely dehydrated DKA, the severe degree of hypernatremia is rarely presented.[1]Hereby we report a case of Type I Diabetes presenting as DKA having hypernatremia.

Keywords: Diabetic ketoacidosis, Type I Diabetes, hypernatremia.

References

  1. Hyung Jin Kim, Dong Hyun Kim, Yong Hoon Jun, et al. A rare diabetes ketoacidosis in combined severe hypernatremic hyperosmolarity in a new-onset Asian adolescent with type I diabetes, BMJ Case Rep 2014. doi:10.1136/bcr-2014-208016
  2. Aidar R Gosmanov, Elvira O Gosmanova, et al. Management of adult diabetic ketoacidosis Diabetes Metab Syndr Obes. 2014; 7: 255–264.
  3. McDonnell CM, Pedreira CC, Vadamalayan B, et al. Diabetic ketoacidosis, hyperosmolarity and hypernatremia: are high-carbohydrate drinks worsening initial presentation? Pediatr Diabetes 2005;6:90–4.
  4. Bhowmick SK, Hundley OT, Rettig KR. Severe hypernatremia and hyperosmolality exacerbated by an herbal preparation in a patient with diabetic ketoacidosis. Clin Pediatr (Phila) 2007;46:831–4.
  5. KW Monroe, WD King, MH Nichols, et al. Hypernatremia in diabetic ketoacidosis, Practical Diabetes International September/ October 1997 Vol. 14 No. 6.

Corresponding Author

Yash Khanvilkar

2nd year Junior  Resident ,Department of  Medicine ,

Adichunchanagiri Institute of Medical Sciences Balagangadharanatha Nagara,

Nagamangala, mandya-571448, Karnataka, India