Diabetic ketoalkalosis: the dark, torrid horse of diabetic emergencies

Abstract

Diabetic ketoalkalosis (DKALK) is a rare but significant variant of diabetic emergencies, characterized by metabolic alkalosis rather than the typical acidosis seen in diabetic ketoacidosis (DKA). Despite its clinical importance, DKALK often goes unrecognized due to limited literature on its presentation and biochemical variables. This work examines the pathophysiology, clinical presentation, diagnostic challenges, management strategies, and implications for clinical practice of DKALK, drawing insights from case studies and research gaps in the field. Notable case studies underscore the diagnostic challenges and emphasize the importance of tailored management strategies for DKALK. Risk assessment involves recognizing predisposing factors such as severe vomiting, alcohol abuse, or concomitant diuretic use. Timely recognition and intervention are essential to prevent potentially life-threatening complications associated with DKALK. Continued research efforts are warranted to refine diagnostic criteria, optimize therapeutic approaches, and enhance early recognition of DKALK, ultimately improving patient outcomes in this challenging clinical scenario.

Keywords

• diabetic ketoalkalosis
• metabolic alkalosis
• diabetic emergencies
• ketoacidosis
• endocrinology