{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:13:38Z","timestamp":1753877618694,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["F30 CA236031"],"award-info":[{"award-number":["F30 CA236031"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Diabetic ketoacidosis (DKA) is an acute, life-threatening metabolic complication of diabetes classically associated with hyperglycemia, metabolic acidosis, and ketosis. Though relatively uncommon, patients can also develop DKA with relative euglycemia, further complicating diagnosis. Here, we describe the case of a patient who presented with intractable vomiting secondary to diabetic gastroparesis. He was euglycemic, non-acidemic, and serum bicarbonate was within normal limits. However, labs were significant for ketonuria, an elevated anion gap, and an elevated beta-hydroxybutyrate. Given the high concern for euglycemic DKA in the setting of a competing primary metabolic alkalosis, he was transferred to the intensive care unit for intravenous insulin infusion and fluid resuscitation with significant clinical improvement and normalization of laboratory results. This serves as an important reminder that DKA can be masked by euglycemia as well as additional metabolic derangements, and should be suspected in any diabetic patient with an anion gap and\/or ketosis.<\/jats:p>","DOI":"10.1093\/omcr\/omae071","type":"journal-article","created":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T11:52:56Z","timestamp":1720957976000},"source":"Crossref","is-referenced-by-count":1,"title":["Diabetic ketoacidosis masked by both Euglycemia and a primary metabolic alkalosis"],"prefix":"10.1093","volume":"2024","author":[{"given":"Matthew F","family":"Hillock","sequence":"first","affiliation":[{"name":"University of Illinois College of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cierra","family":"Jarmon","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia E","family":"Metropulos","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"King","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-1210","authenticated-orcid":false,"given":"Stefan","family":"Tchernodrinski","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4355-6597","authenticated-orcid":false,"given":"Daniel R","family":"Principe","sequence":"additional","affiliation":[{"name":"University of Illinois College of Medicine , Chicago, IL, United States"},{"name":"Northwestern University Feinberg School of Medicine , Chicago, IL, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,13]]},"reference":[{"volume-title":"Ketoacidosis","year":"2024","author":"Ghimire","key":"2024071411524890600_ref1"},{"volume-title":"Euglycemic Diabetic Ketoacidosis","year":"2024","author":"Plewa","key":"2024071411524890600_ref2"},{"key":"2024071411524890600_ref3","doi-asserted-by":"crossref","first-page":"108744","DOI":"10.1016\/j.diabres.2021.108744","article-title":"Management of diabetic ketoacidosis in special populations","volume":"174","author":"Eledrisi","year":"2021","journal-title":"Diabetes Res Clin Pract"},{"key":"2024071411524890600_ref4","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.2337\/dc15-0843","article-title":"Euglycemic diabetic ketoacidosis: a potential complication of treatment with sodium-glucose cotransporter 2 inhibition","volume":"38","author":"Peters","year":"2015","journal-title":"Diabetes Care"},{"key":"2024071411524890600_ref5","doi-asserted-by":"crossref","first-page":"514","DOI":"10.4239\/wjd.v12.i5.514","article-title":"Euglycemic diabetic ketoacidosis: a missed diagnosis","volume":"12","author":"Nasa","year":"2021","journal-title":"World J Diabetes"},{"volume-title":"Adult Diabetic Ketoacidosis","year":"2024","author":"Lizzo","key":"2024071411524890600_ref6"},{"key":"2024071411524890600_ref7","first-page":"e25818","article-title":"A rare case of Empagliflozin-induced Euglycemic diabetic ketoacidosis obscured by alkalosis","volume":"14","author":"Fernandez Felix","year":"2022","journal-title":"Cureus"},{"key":"2024071411524890600_ref8","doi-asserted-by":"crossref","first-page":"e8250","DOI":"10.1002\/ccr3.8250","article-title":"Metabolic alkalosis masked presentation of diabetic ketoacidosis: a case report","volume":"11","author":"Wuttiputhanun","year":"2023","journal-title":"Clin Case Rep"},{"key":"2024071411524890600_ref9","doi-asserted-by":"crossref","first-page":"481","DOI":"10.2337\/dc21-1730","article-title":"Differentiating diabetic ketoacidosis and Hyperglycemic ketosis due to cannabis hyperemesis syndrome in adults with type 1 diabetes","volume":"45","author":"Akturk","year":"2022","journal-title":"Diabetes Care"},{"key":"2024071411524890600_ref10","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvad114.876","article-title":"FRI658 diabetic ketoacidosis masked by cannabis In type 2 diabetes mellitus","volume":"7","author":"Bosques-Lorenzo","year":"2023","journal-title":"J Endocr Soc"}],"container-title":["Oxford Medical Case 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