Severe diabetic ketoacidosis with hyperosmolar hyperglycaemic state after an adolescent's exclusion from collective

Abstract

Combined state of diabetic ketoacidosis with hyperosmolar hyperglycaemic state complicates acute treatment and increases the risk of brain oedema. Paediatric diabetologist can encounter it in adolescents especially when they do not apply insulin because of their peers.

The case report, dealing with maladaptation at a ski course, describes the treatment of an adolescent girl, which began at pH 6.86, base excess -29.3 mmol/l, glycaemia 55.1 mmol/l, and osmolality 353 mOsmol/kg.

Keywords

• type 1 diabetes mellitus
• diabetic ketoacidosis
• hyperosmolar hyperglycaemic state
• combined state