Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis

Diabetes mellitus (DM) is a clinical syndrome that is manifested by hyperglycemia. Out of the numerous causes of diabetes, an uncommon cause is chronic pancreatic disease due to destruction of islet cells. Diabetic ketoacidosis is a rare entity in such cases as alpha cells are destroyed along with b...

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Main Authors: Ujjawal K. Shriwastav, Mayank Agarwal, Rohit Raina, Ravi Kant
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-06-01
Series:Journal of Family Medicine and Primary Care
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Online Access:https://journals.lww.com/10.4103/jfmpc.jfmpc_1665_22
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author Ujjawal K. Shriwastav
Mayank Agarwal
Rohit Raina
Ravi Kant
author_facet Ujjawal K. Shriwastav
Mayank Agarwal
Rohit Raina
Ravi Kant
author_sort Ujjawal K. Shriwastav
collection DOAJ
description Diabetes mellitus (DM) is a clinical syndrome that is manifested by hyperglycemia. Out of the numerous causes of diabetes, an uncommon cause is chronic pancreatic disease due to destruction of islet cells. Diabetic ketoacidosis is a rare entity in such cases as alpha cells are destroyed along with beta cells, which causes lack of glucagon that is responsible for ketogenesis. We hereby report a case of a 55-year-old woman with history of gall stone disease and who presented to the emergency department with multiple episodes of non-bilious, non-blood mixed vomiting along with increased frequency of micturition on background of malaise and anorexia along with significant weight loss. Her capillary blood glucose was 501 mg/dl, arterial blood gas showed high anion gap metabolic acidosis, and urine ketone were largely positive. Thus, she was diagnosed with diabetic ketoacidosis. She was admitted to the high dependency unit and her condition was treated along the lines of diabetic ketoacidosis. Further evaluation showed high HbA1c values without previous history of diabetes and computed tomography of the abdomen revealed presence of chronic pancreatitis. Though being a rare entity, this case outlines that DM3c can present with diabetic ketoacidosis (DKA); thus, early diagnosis and management are crucial to prevent mortality.
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spelling doaj-art-0ac4716c6922401e87dd9b88d5a1d8452024-11-11T11:08:01ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352023-06-011261226122810.4103/jfmpc.jfmpc_1665_22Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitisUjjawal K. ShriwastavMayank AgarwalRohit RainaRavi KantDiabetes mellitus (DM) is a clinical syndrome that is manifested by hyperglycemia. Out of the numerous causes of diabetes, an uncommon cause is chronic pancreatic disease due to destruction of islet cells. Diabetic ketoacidosis is a rare entity in such cases as alpha cells are destroyed along with beta cells, which causes lack of glucagon that is responsible for ketogenesis. We hereby report a case of a 55-year-old woman with history of gall stone disease and who presented to the emergency department with multiple episodes of non-bilious, non-blood mixed vomiting along with increased frequency of micturition on background of malaise and anorexia along with significant weight loss. Her capillary blood glucose was 501 mg/dl, arterial blood gas showed high anion gap metabolic acidosis, and urine ketone were largely positive. Thus, she was diagnosed with diabetic ketoacidosis. She was admitted to the high dependency unit and her condition was treated along the lines of diabetic ketoacidosis. Further evaluation showed high HbA1c values without previous history of diabetes and computed tomography of the abdomen revealed presence of chronic pancreatitis. Though being a rare entity, this case outlines that DM3c can present with diabetic ketoacidosis (DKA); thus, early diagnosis and management are crucial to prevent mortality.https://journals.lww.com/10.4103/jfmpc.jfmpc_1665_22chronic pancreatitisdiabetic ketoacidosisdiabetes mellitus type 3cpancreatogenic diabetes
spellingShingle Ujjawal K. Shriwastav
Mayank Agarwal
Rohit Raina
Ravi Kant
Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
Journal of Family Medicine and Primary Care
chronic pancreatitis
diabetic ketoacidosis
diabetes mellitus type 3c
pancreatogenic diabetes
title Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
title_full Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
title_fullStr Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
title_full_unstemmed Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
title_short Pancreatogenic diabetes presenting with diabetic ketoacidosis: A rare manifestation of chronic pancreatitis
title_sort pancreatogenic diabetes presenting with diabetic ketoacidosis a rare manifestation of chronic pancreatitis
topic chronic pancreatitis
diabetic ketoacidosis
diabetes mellitus type 3c
pancreatogenic diabetes
url https://journals.lww.com/10.4103/jfmpc.jfmpc_1665_22
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AT rohitraina pancreatogenicdiabetespresentingwithdiabeticketoacidosisararemanifestationofchronicpancreatitis
AT ravikant pancreatogenicdiabetespresentingwithdiabeticketoacidosisararemanifestationofchronicpancreatitis