Background Diabetic ketoacidosis (DKA) is the most common complication of diabetes mellitus. DKA results from absolute or relative deficiency of circulating insulin and from combined effects of increased counter regulatory hormone levels. The combination of low serum insulin and high counter regulatory hormone concentrations accelerate catabolic state with increased glucose production by liver ...

Rhabdomyolysis has been reported to be associated with hyperosmolality in diabetic ketoacidosis and non-ketotic hyperosmolal state. Whether the rhabdomyolysis was due to hyperosmolality per se or whether hyperglycaemia also played a role is not clear. We hereby report a case of cranial diabetes insipidus with hypernatraemia and hyperosmolality complicated by rhabdomyolysis. None of the known ri...

Tubular function was investigated in patients with diabetic ketoacidosis and those with poorly controlled type I diabetes. Urinary excretion of beta 2 microglobulin and that of certain enzymes: gamma glutamyltransferase, leucine aminopeptidase, and N-acetyl-beta-D-glucosaminidase activities were significantly raised during ketoacidosis in 11 patients compared with healthy controls. In 13 poorly...

Strict restriction of carbohydrates can induce symptomatic ketoacidosis. We herein report a 76-year-old demented woman who developed ketoacidosis after 1 month of abnormal eating behavior involving selectively eating hamburger steak (estimated carbohydrate =12.7 g/day). Laboratory tests showed high-anion-gap metabolic acidosis with elevated blood ketone levels. She was successfully treated with...

A case is reported of a young patient who presented to University Department of Pediatrics in Prishtina with a newly diagnosed diabetes in December 2006. On admission, the patient showed severe ketoacidosis due to the late diagnosis, in spite of two prior visits to a general practitioner. Biochemistry results on admission included serum glucose 35 mmol/L, venous pH 6.9, bicarbonates 4.8 mmol/L,...

OBJECTIVE To determine the course of brittle diabetes. DESIGN 12 year follow up of patients identified in 1977-9 as having brittle diabetes; retrospective review of the case notes. SETTING Nottingham health district. SUBJECTS 25 brittle diabetic patients were identified in 1979-9; 11 (five men) had three or more admissions with ketoacidosis between June 1977 and 1979 and 14 (eight men) ha...

Two brothers with DIDMOAD syndrome are reported. The older brother has diabetes mellitus (type I), diabetes insipidus, optic atrophy, deafness and atonia of the urinary tract with severe symptoms such as diabetic ketoacidosis and frequent urinary tract infections. His younger brother had the same manifestations but with less severity. We report the findings of our two patients and compare ...

To the Editor—I read with interest “Olanzapine-induced diabetic ketoacidosis in a Chinese Man” by Wong et al published in the February 2007 issue.1 Although the patient did develop diabetic ketoacidosis while taking olanzapine and this association has been noticed previously with olanzapine as well as with other firstor second-generation antipsychotics, it is somewhat presumptuous to assume ola...

Proprotein convertase 1/3 (PC1/3) deficiency is a very rare disease characterized by severe intractable diarrhea in the first years of life, followed by obesity and several hormonal deficiencies later. Diabetes mellitus requiring insulin treatment and diabetic ketoacidosis have not been reported in this disorder. We herein present a girl with PC1/3 deficiency who has been followed from birth to...