[Diabetic ketoacidosis in a patient with acromegaly, a case report]

ABSTRACT

Although impaired glucose tolerance affects 36% and overt diabetes mellitus can be seen in 30% of cases with acromegaly, diabetic ketoacidosis is rarely reported in patients with this disease. We present an unusual complication of acromegaly a 22 year old woman with amenorrhea [6 month age] and blurred vision of left eye [4 month ago] referred to Ghaem neurology clinic in Mashhad. With a growth hormone [GH] level of = 100 ng/ml, Insulin like growth Factor-1 [IGF-1] =1560 ng/ ml and pituitary macro adenoma in magnetic resonance imaging [MRI], she was candidated for surgery. A few hours before surgery she had dyspnea, loss of consciousness, fever and with blood sugar [BS] =500 mg/ml, Hco3 = 2.4, PH=7.06 and keton in urine. Diabetic ketoacidosis was diagnosed. The patient was treated with high dose of insulin [500 IU/day] and hydration. After octerotide administration the need for insulin decreased and after pituitary adenectomy, there was no need for insulin therapy and the patient was discharged on metformin [one tablet per day]