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Severe metabolic derangement: a case of concomitant diabetic ketoacidosis and beer potomania
  1. Dmitriy Stasishin,
  2. Patrick Schaffer,
  3. Zeryab Khan and
  4. Christie Murphy
  1. Internal Medicine, Doctors Hospital OhioHealth, Columbus, Ohio, USA
  1. Correspondence to Dr Christie Murphy; cmazurk1{at}


Diabetic ketoacidosis (DKA) and hyponatraemia associated with beer potomania are severe diagnoses warranting intensive care level management. Our patient, a middle-aged man, with a history of chronic alcohol abuse and insulin non-compliance, presents with severe DKA and severe hyponatraemia. Correcting sodium and metabolic derangements in each disorder require significant attention to fluid and electrolyte levels. Combined they prove challenging and require an individualised approach to prevent the overcorrection of sodium. Furthermore, management of these conditions lends to the importance of understanding the pathophysiology behind their hormonal and osmotic basis.

  • diabetes
  • metabolic disorders
  • medical management
  • alcohol-related disorders
  • fluid electrolyte and acid-base disturbances

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  • Contributors DS is the primary author. Contributed the majority of the discussion section and formatting of the case. Provided emphasis on the endocrinological elements. PS provided insight into the hyponatraemia elements of the case. Assisted with editing and discussion section. ZK provided work on the case manuscript and information regarding the EMR review of the patient’s care as well as insight into their daily changes. Assisted with formatting and source research. CM provided mentorship and assistance with formatting and publication advice.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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