Specimen Name Result Units Range
Plasma Sodium 129 mmol/L (135-145)
Potassium 5.3 mmol/L (3.5-5.5)
Chloride 102 mmol/L (100-109)
Bicarbonate 3 mmol/L (22-32)
Glucose 19 mmol/L (3.8-5.5)
Urea 8.6 mmol/L (2.7-7.2)
Creatinine 120 μmol/L (60-110)

19yo female.

Rapid onset of general malaise, confusion & nausea.
'Euglycaemia' Ketoacidosis
  • up to 18% of diabetic emergencies
  • typically younger type-I diabetics
  • rapid onset - within hours

Clinical Features:

  • Present with hyperventilation but "look well"
  • Coma and dehydration rare
  • Investigations
    • severe ketoacidosis
    • "normal " glucose - usually < 15 mmol/L, but up to 20 mmol/L
    • osmolality only slightly elevated

Treatment:

  • IVT with N-saline, then D5W
  • Insulin in 'normal ' doses

Absence of marked hyperglycaemia:

  • rapid onset / short duration
  • normal renal function and ECF volume
  • subsequent marked glycosuria