Diabetic ketoachidosis in a patient with acromegaly
Journal
Journal of the Formosan Medical Association
Journal Volume
106
Journal Issue
9
Pages
788-791
Date Issued
2007
Author(s)
Abstract
Diabetes mellitus develops in about 10% of acromegalic patients, usually secondary to insulin resistance caused by growth hormone excess. Diabetic ketoacidosis is a result of relative insulin deficiency and is a rare feature of acromegaly. Here, we present one case of this disorder. A 57-year-old man came to the emergency room due to 2 weeks of dizziness. He also had polyuria, polydipsia, nausea, diplopia, blurred vision and dysarthria. His plasma glucose level was 32.06 mmol/L, plasma osmolarity was 322 mOsm/L, arterial pH was 7.30, level of bicarbonates was 18 mmol/L, urine ketones was 4+, and HbA1c was 14.1%. No specific cause for the development of this metabolic derangement could be found. He displayed clinical features of acromegaly during admission, which was confirmed by an elevated growth hormone level and pituitary macroadenoma shown on magnetic resonance imaging. The patient underwent total transsphenoid tumor removal 2 weeks later; plasma glucose levels became normal thereafter. ?2007 Elsevier & Formosan Medical Association.
SDGs
Other Subjects
acarbose; bicarbonate; glibenclamide; glucose; growth hormone; hemoglobin A1c; insulin; ketone; metformin; oral antidiabetic agent; acromegaly; adult; arterial pH; article; blurred vision; case report; clinical feature; diabetic ketoacidosis; diplopia; dizziness; dysarthria; glucose blood level; glycemic control; hemoglobin blood level; hormone determination; human; hypophysis adenoma; immunochemistry; laboratory test; male; nausea; nuclear magnetic resonance imaging; physical examination; plasma osmolarity; polydipsia; polyuria; postoperative care; transsphenoidal surgery; urinalysis; acromegaly; diabetic ketoacidosis; middle aged; Acromegaly; Diabetic Ketoacidosis; Humans; Male; Middle Aged
Publisher
Scientific Communications International Ltd
Type
journal article