Postoperative Euglycemic Diabetic Ketoacidosis

DiscussionDKA consists of hyperglycemia (blood sugar levels >250 mg/dL), metabolic acidosis (pH of <7.3 and bicarbonate levels <15 mEq/L), and ketosis. 3 The body's regulation of blood sugar levels is achieved through a harmonious interplay between insulin and hormones that act in opposition, such as glucagon, growth hormone, cortisol, and adrenaline.Diabetic ketoacidosis occurs when the level of insulin reduces and the levels of counteractive hormones rise causing hyperglycemia. 1 Cells and tissues are unable to utilize the available glucose even though it is in excess due to a lack of insulin, which results in lipolysis leading to undue production of ketone bodies. 4 In this case report, we present a case of ketoacidosis but without hyperglycemia.EDKA develops when the liver's production of glucose (gluconeogenesis) diminishes during periods without food intake (fasting) or when excessive amounts of glucose are eliminated through the urine.Therefore, when a diabetic patient experiences factors that can trigger DKA or goes without food for extended periods (starvation), their liver's stores of glycogen become depleted, resulting in a reduced ability to produce glucose.