{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T07:52:30Z","timestamp":1783151550530,"version":"3.54.6"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,13]]},"abstract":"<jats:p>Usually, hyperglycaemia crisis presents with acidotic pH, but ketoalkalosis is a rare and unheard entity presenting in diabetic ketoacidosis. We describe three unique cases where the patients present with hyperglycaemia &gt;250\u2009mg\/dL, normal or alkalotic pH, and bicarbonate &gt;20 meq\/L, which does not meet criteria for diabetic ketoacidosis. However, once these patients were supplemented with intravenous fluids, diagnosis of diabetic ketoacidosis was evident in laboratory analysis. These case series provide a learning opportunity in diagnosing and management of this rare phenomenon.<\/jats:p>","DOI":"10.1136\/bcr-2018-226092","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T13:15:28Z","timestamp":1538486128000},"page":"bcr-2018-226092","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Diabetic ketoalkalosis: misnomer or undiagnosed variant of diabetic ketoacidosis"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5452-2483","authenticated-orcid":false,"given":"Sushant","family":"Nanavati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Melki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monisha","family":"Singhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,10,2]]},"reference":[{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.14740\/jem472w","article-title":"Ketoalkalosis: Masked Presentation of Diabetic Ketoacidosis With Literature Review","volume":"7","author":"Kumar","year":"2017","journal-title":"J Endocrinol Metab"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.2","first-page":"3","article-title":"Ketosis not always acidosis: \u2018\u2018heartburn\u2019\u2019 can be relevant","volume":"2","author":"Bleicher","year":"1967","journal-title":"Diabetes"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/SMJ.0000000000000040","article-title":"Diabetic ketoalkalosis in children and adults","volume":"107","author":"Huggins","year":"2014","journal-title":"South Med J"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1207788"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(96)01332-0"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.6","doi-asserted-by":"publisher","DOI":"10.2337\/diaclin.33.1.37"},{"key":"2025042706280507000_2018.oct02_1.bcr-2018-226092.7","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1053\/ajem.2001.27167","article-title":"Diabetic ketoacidosis with alkalemia","volume":"19","author":"Jerrard","year":"2001","journal-title":"Am J Emerg Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:28:14Z","timestamp":1745760494000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,2]]},"references-count":7,"alternative-id":["10.1136\/bcr-2018-226092"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226092","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,2]]}}}