Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Endocrinology
Volume 2018, Article ID 4806598, 3 pages
https://doi.org/10.1155/2018/4806598
Case Report

A Case of Diabetic Ketoacidosis Presenting with Hypernatremia, Hyperosmolarity, and Altered Sensorium

1Department of Internal Medicine, St. Joseph’s University Medical Center-New York Medical College, USA
2Department of Family Medicine, St. Joseph’s University Medical Center-New York Medical College, USA
3Department of Endocrinology, St. Joseph’s University Medical Center-New York Medical College, USA

Correspondence should be addressed to Sushant M. Nanavati; moc.liamg@2vanans

Received 13 April 2018; Accepted 2 July 2018; Published 16 July 2018

Academic Editor: Hyunsik Kang

Copyright © 2018 Vinod Kumar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Diabetic Ketoacidosis commonly presents with hyponatremia, but hypernatremia is a rare entity. We report a unique case of a 50-year-old woman admitted with altered sensorium with blood glucose 979 milligrams/deciliter, serum osmolarity 363 mOsm/kilograms, and serum sodium 144 milliequivalents/liter. Patient was given initial bolus of isotonic saline and continued on half isotonic saline for correction of hypernatremia along with insulin infusion therapy. Patient was successfully treated with intravenous fluids, insulin infusion, and the altered sensorium was resolved without any sequelae. This case illustrates a teaching point in the use of intravenous fluids for the treatment of Diabetic Ketoacidosis with hypernatremia.