4.1 Article

Severe metabolic derangement: a case of concomitant diabetic ketoacidosis and beer potomania

Journal

BMJ CASE REPORTS
Volume 14, Issue 8, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2021-243486

Keywords

diabetes; metabolic disorders; medical management; alcohol-related disorders; fluid electrolyte and acid-base disturbances

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Diabetic ketoacidosis and hyponatraemia associated with beer potomania are severe diagnoses that require intensive care level management. Correcting sodium and metabolic derangements in each disorder needs significant attention to fluid and electrolyte levels, with individualized approach to prevent overcorrection being essential. Understanding the pathophysiology behind hormonal and osmotic basis of these conditions is crucial in their management.
Diabetic ketoacidosis (DKA) and hyponatraemia associated with beer potomania are severe diagnoses warranting intensive care level management. Our patient, a middle-aged man, with a history of chronic alcohol abuse and insulin non-compliance, presents with severe DKA and severe hyponatraemia. Correcting sodium and metabolic derangements in each disorder require significant attention to fluid and electrolyte levels. Combined they prove challenging and require an individualised approach to prevent the overcorrection of sodium. Furthermore, management of these conditions lends to the importance of understanding the pathophysiology behind their hormonal and osmotic basis.

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