Diabetic Ketoacidosis Complicated by Hypertriglyceridemia-Induced Pancreatitis: A Case Report  

作　　者：Imran Khan Adrienne Kwong Caitlin Richler Christine Landry Sydney Morin Pierre Thabet Imran Khan;Adrienne Kwong;Caitlin Richler;Christine Landry;Sydney Morin;Pierre Thabet(School of Pharmaceutical Sciences, University of Ottawa, Ottawa, Canada;Hpital Montfort, Ottawa, Canada;Institut du Savoir Montfort, Ottawa, Canada;The Ottawa Hospital, Ottawa, Canada)

机构地区：[1]School of Pharmaceutical Sciences, University of Ottawa, Ottawa, Canada [2]Hpital Montfort, Ottawa, Canada [3]Institut du Savoir Montfort, Ottawa, Canada [4]The Ottawa Hospital, Ottawa, Canada

出　　处：《Case Reports in Clinical Medicine》2024年第12期587-596,共10页临床医学病理报告(英文)

摘　　要：Background: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. It can lead to complications such as hypertriglyceridemia-induced pancreatitis due to increased lipolysis and triglyceride formation. Case Presentations: A 28-year-old female presented with symptoms consistent with diabetic ketoacidosis (DKA), including polyuria, polydipsia, polyphagia, and unintentional weight loss. Laboratory results revealed severe hyperglycemia (glucose 22.9 mmol/L, HbA1c 14.5%), metabolic acidosis (pH 7.15), and elevated beta-hydroxybutyrate (6.75 mmol/L). Further evaluation showed markedly elevated triglycerides (45 mmol/L) and lipase (2928 IU/L), indicating mild pancreatitis. Upon reviewing her clinical presentation and lab findings, poorly controlled diabetes was determined to be the primary cause, leading to DKA and secondary hypertriglyceridemia. The patient was managed in the ICU with insulin therapy, fluid resuscitation, and Fenofibrate to address hypertriglyceridemia. Identifying the primary precipitant through this comprehensive assessment is crucial for directing management toward aggressive control of hyperglycemia, ketosis, and triglyceride levels. Conclusions: This case underscores the complex interplay between DKA, hypertriglyceridemia, and pancreatitis. Accurate clinical evaluation is essential to tailor management strategies focusing on aggressive control of hyperglycemia and triglyceride levels to prevent complications and optimize patient outcomes.Background: Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by hyperglycemia, metabolic acidosis, and ketosis. It can lead to complications such as hypertriglyceridemia-induced pancreatitis due to increased lipolysis and triglyceride formation. Case Presentations: A 28-year-old female presented with symptoms consistent with diabetic ketoacidosis (DKA), including polyuria, polydipsia, polyphagia, and unintentional weight loss. Laboratory results revealed severe hyperglycemia (glucose 22.9 mmol/L, HbA1c 14.5%), metabolic acidosis (pH 7.15), and elevated beta-hydroxybutyrate (6.75 mmol/L). Further evaluation showed markedly elevated triglycerides (45 mmol/L) and lipase (2928 IU/L), indicating mild pancreatitis. Upon reviewing her clinical presentation and lab findings, poorly controlled diabetes was determined to be the primary cause, leading to DKA and secondary hypertriglyceridemia. The patient was managed in the ICU with insulin therapy, fluid resuscitation, and Fenofibrate to address hypertriglyceridemia. Identifying the primary precipitant through this comprehensive assessment is crucial for directing management toward aggressive control of hyperglycemia, ketosis, and triglyceride levels. Conclusions: This case underscores the complex interplay between DKA, hypertriglyceridemia, and pancreatitis. Accurate clinical evaluation is essential to tailor management strategies focusing on aggressive control of hyperglycemia and triglyceride levels to prevent complications and optimize patient outcomes.

关 键 词：Diabetic Ketoacidosis HYPERTRIGLYCERIDEMIA PANCREATITIS Insulin Therapy FENOFIBRATE 

分 类 号：R58[医药卫生—内分泌]