{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:16:02Z","timestamp":1772151362801,"version":"3.50.1"},"reference-count":19,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Caffeine is a widely consumed stimulant contained in beverages and supplements, and intentional overdose is becoming increasingly common. Although hyperglycemia is often seen in caffeine toxicity, diabetic ketoacidosis (DKA) is a rare complication, particularly in those without a known history of diabetes. We report the case of a 46-year-old man without a known medical history who ingested 10\u2005g of caffeine to attempt suicide. He presented with impaired consciousness, arrhythmia, hyperglycemia, and metabolic acidosis. Laboratory testing confirmed DKA, and endoscopy revealed esophageal severe erosions and a duodenal ulcer. He was managed with IV fluids, insulin infusion, sedation, potassium-competitive acid blocker, and \u03b2-blocker therapy. After stabilization, he was diagnosed with type 2 diabetes mellitus. The condition was characterized by insulin resistance and preserved endogenous insulin secretion, which allowed discontinuation of insulin therapy. He recovered fully and was discharged without diabetic medications. This case highlights the importance of considering DKA in patients with caffeine overdose, especially those with unrecognized diabetes, and the potential for gastrointestinal injury. Clinicians should be aware of these rare but serious complications to ensure prompt diagnosis and management.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf276","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T13:15:31Z","timestamp":1761830131000},"source":"Crossref","is-referenced-by-count":1,"title":["Caffeine Overdose-Induced Diabetic Ketoacidosis With Gastrointestinal Injury in Undiagnosed Type 2 Diabetes"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6579-486X","authenticated-orcid":false,"given":"Hikari","family":"Kohmoto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Uotsu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuhiro","family":"Masaoka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]},{"name":"Center for Endoscopy, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kawasaki Municipal Hospital , Kawasaki, Kanagawa 210-0013 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"issue":"5","key":"2025121510321809700_luaf276-B1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.3390\/nu10050611","article-title":"Caffeine-related deaths: manner of deaths and categories at risk","volume":"10","author":"Cappelletti","year":"2018","journal-title":"Nutrients"},{"issue":"5","key":"2025121510321809700_luaf276-B2","first-page":"4102","article-title":"Scientific opinionon the safety of caffeine","volume":"13","author":"EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies)","year":"2015","journal-title":"EFSA 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