Not all ketosis is type 1 - remember Flatbush

Br J Hosp Med (Lond). 2024 Jul 30;85(7):1-4. doi: 10.12968/hmed.2024.0091. Epub 2024 Jul 16.

Abstract

A 35-year-old otherwise healthy gentleman from Togo, was referred as a 'walk-in' to our clinic with polyuria and polydipsia, and a glycated haemoglobin (Hba1c) of 119 mmol/mol (13.1%). The patient also noted 5kg weight loss over a short span of time. He had a significant family history of Type 2 Diabetes Mellitus (T2DM). Initial blood tests revealed a blood glucose of 22.84 mmol/L, with positive ketones (1.2 mmol/L). Urinalysis showed glycosuria (1000 mg/dL) but was negative for nitrites and white cells. Renal, liver and thyroid function tests were all within normal limits. He had mild metabolic acidosis.

Keywords: Atypical diabetes; Autoantibodies; Diabetic ketoacidosis; Ketosis-prone diabetes.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 2*
  • Diabetic Ketoacidosis / diagnosis
  • Diagnosis, Differential
  • Glycated Hemoglobin / analysis
  • Humans
  • Ketosis / diagnosis
  • Ketosis / etiology
  • Male
  • Polyuria / etiology

Substances

  • Glycated Hemoglobin
  • Blood Glucose