Strawberry pink blood: hypertriglyceridaemia and diabetic ketoacidosis secondary to poorly controlled type 2 diabetes mellitus
A 54-year-old woman with insulin-requiring type 2 diabetes mellitus presented with acute shortness of breath and drowsiness on a background of polydipsia, weakness and significant weight loss. One year ago, she had decided to stop her insulin and other medications and adopt lifestyle modifications i...
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| Published in | BMJ case reports Vol. 14; no. 8; p. e243696 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
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20.08.2021
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| Abstract | A 54-year-old woman with insulin-requiring type 2 diabetes mellitus presented with acute shortness of breath and drowsiness on a background of polydipsia, weakness and significant weight loss. One year ago, she had decided to stop her insulin and other medications and adopt lifestyle modifications instead. Initial emergency department (ED) blood samples were highly lipaemic and appeared strawberry pink. She was eventually diagnosed with diabetic ketoacidosis (DKA) with severe hypertriglyceridaemia, intubated for airway protection, and managed with fluid resuscitation and intravenous insulin to good effect. We share an uncommon DKA presentation at the ED. History was limited as the patient was drowsy and minimally communicative. Physical examination was unremarkable. Blood investigations were also delayed in view of the need for additional centrifugation. These contributed to a paucity of information in the acute setting and resulted in a diagnostic challenge. |
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| AbstractList | A 54-year-old woman with insulin-requiring type 2 diabetes mellitus presented with acute shortness of breath and drowsiness on a background of polydipsia, weakness and significant weight loss. One year ago, she had decided to stop her insulin and other medications and adopt lifestyle modifications instead. Initial emergency department (ED) blood samples were highly lipaemic and appeared strawberry pink. She was eventually diagnosed with diabetic ketoacidosis (DKA) with severe hypertriglyceridaemia, intubated for airway protection, and managed with fluid resuscitation and intravenous insulin to good effect. We share an uncommon DKA presentation at the ED. History was limited as the patient was drowsy and minimally communicative. Physical examination was unremarkable. Blood investigations were also delayed in view of the need for additional centrifugation. These contributed to a paucity of information in the acute setting and resulted in a diagnostic challenge. |
| Author | Lim, Steven Hoon Chin Khoo, Joan Tan, Timothy Xin Zhong |
| AuthorAffiliation | 1 Department of Emergency Medicine , Changi General Hospital , Singapore 2 Department of Endocrinology , Changi General Hospital , Singapore |
| AuthorAffiliation_xml | – name: 2 Department of Endocrinology , Changi General Hospital , Singapore – name: 1 Department of Emergency Medicine , Changi General Hospital , Singapore |
| Author_xml | – sequence: 1 givenname: Timothy Xin Zhong orcidid: 0000-0001-5938-2304 surname: Tan fullname: Tan, Timothy Xin Zhong email: timothy.tbj13@gmail.com organization: Department of Emergency Medicine, Changi General Hospital, Singapore – sequence: 2 givenname: Steven Hoon Chin surname: Lim fullname: Lim, Steven Hoon Chin email: timothy.tbj13@gmail.com organization: Department of Emergency Medicine, Changi General Hospital, Singapore – sequence: 3 givenname: Joan surname: Khoo fullname: Khoo, Joan email: timothy.tbj13@gmail.com organization: Department of Endocrinology, Changi General Hospital, Singapore |
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| SubjectTerms | Abdomen Acidosis Blood tests Cardiac arrhythmia Case Report Case reports Diabetes Diabetic ketoacidosis Drug overdose Electrolytes Glucose Hyperkalemia Hypokalemia Insulin Laboratories Malnutrition Metabolism Pancreatitis Sepsis Triglycerides |
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| Title | Strawberry pink blood: hypertriglyceridaemia and diabetic ketoacidosis secondary to poorly controlled type 2 diabetes mellitus |
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