Skip to main content
  • More from ADA
    • Diabetes
    • Diabetes Care
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Clinical Diabetes

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
  • Browse
    • Issue Archive
    • Saved Searches
    • COVID-19 Article Collection
    • Quality Improvement Sucess Stories
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
  • Advertising
  • Reprints/Reuse
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • Instructions for Authors
    • ADA Journal Policies
  • More from ADA
    • Diabetes
    • Diabetes Care
    • Diabetes Spectrum
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • My Cart

Search

  • Advanced search
Clinical Diabetes
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
  • Browse
    • Issue Archive
    • Saved Searches
    • COVID-19 Article Collection
    • Quality Improvement Sucess Stories
    • ADA Standards of Medical Care
    • ADA Standards of Medical Care, Abridged
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
  • Advertising
  • Reprints/Reuse
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • Instructions for Authors
    • ADA Journal Policies
Case Studies

Diabetic Ketoacidosis in a Type 2 Diabetes Patient After Initiation of Over-the-Counter Weight Loss Medications: A Cautionary Tale

  1. Kamilya A. Gosmanova1 and
  2. Aidar R. Gosmanov1,2
  1. 1Albany Medical College, Albany, NY
  2. 2Section of Endocrinology, Stratton VA Medical Center, Albany, NY
  1. Corresponding author: Aidar R. Gosmanov, aidar.gosmanov{at}va.gov or agosmanov{at}gmail.com
Clinical Diabetes 2020 Oct; 38(4): 408-411. https://doi.org/10.2337/cd20-0024
PreviousNext
  • Article
  • Info & Metrics
  • PDF
Loading

Case Presentation

A 50-year-old Caucasian man with a history of obesity and type 2 diabetes presented to the emergency room with a 2-day history of blurry vision and severe polyuria and polydipsia. He was found to have diabetic ketoacidosis (DKA) and was admitted to the hospital for further management; endocrinology service was subsequently consulted. Review of his chart showed that he had been diagnosed with type 2 diabetes about 2 years before this admission when at an annual screening his A1C was 6.6% (49 mmol/mol). Metformin monotherapy was then started; however, he quickly stopped the medication because of gastrointestinal upset. He further improved his diet and increased his physical activity and, about 6 months before his admission with DKA, his primary care provider had changed his follow-up visits to once per year because his A1C was 6.1% (43 mmol/mol), his blood pressure was 130/78 mmHg, random LDL cholesterol was 115 mg/dL, and triglycerides were 304 mg/dL. No medications were prescribed.

At the time of his admission with hyperglycemic emergency, the diagnosis of DKA was made based on a serum glucose level of 621 mg/dL, bicarbonate of 20 mEq/L (normal range 22–32), anion gap of 19, and presence of serum ketones. The DKA episode was resolved 10 hours after admission to the intensive care unit (ICU) for intravenous fluid resuscitation and insulin therapy.

During initial inpatient evaluation, we found no signs or symptoms supporting concurrent infection or pancreatitis; he was hemodynamically stable and had a BMI of 32 kg/m2, with a weight of 85 kg. His A1C was 12.8% (116 mmol/mol), triglycerides were 7,783 mg/dL, and total cholesterol was 411 mg/dL; thyroid-stimulating hormone and liver function tests were within normal limits.

As he was transferred from ICU to the floor to receive basal-bolus insulin therapy, further history was obtained from the …

View Full Text

Log in using your username and password

Forgot your user name or password?

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.
PreviousNext
Back to top
Clinical Diabetes: 38 (4)

In this Issue

October 2020, 38(4)
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by Author
  • Masthead (PDF)
Sign up to receive current issue alerts
View Selected Citations (0)
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Clinical Diabetes.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Diabetic Ketoacidosis in a Type 2 Diabetes Patient After Initiation of Over-the-Counter Weight Loss Medications: A Cautionary Tale
(Your Name) has forwarded a page to you from Clinical Diabetes
(Your Name) thought you would like to see this page from the Clinical Diabetes web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Diabetic Ketoacidosis in a Type 2 Diabetes Patient After Initiation of Over-the-Counter Weight Loss Medications: A Cautionary Tale
Kamilya A. Gosmanova, Aidar R. Gosmanov
Clinical Diabetes Oct 2020, 38 (4) 408-411; DOI: 10.2337/cd20-0024

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

Diabetic Ketoacidosis in a Type 2 Diabetes Patient After Initiation of Over-the-Counter Weight Loss Medications: A Cautionary Tale
Kamilya A. Gosmanova, Aidar R. Gosmanov
Clinical Diabetes Oct 2020, 38 (4) 408-411; DOI: 10.2337/cd20-0024
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Case Presentation
    • Questions
    • Commentary
    • Clinical Pearls
    • Article Information
    • References
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Isolation and Education During a Pandemic: Novel Telehealth Approach to Family Education for a Child With New-Onset Type 1 Diabetes and Concomitant COVID-19
  • Euglycemic Diabetic Ketoacidosis in a Patient Prescribed Empagliflozin and a Ketogenic Diet: A Case of Misdiagnosed Type 1 Diabetes
  • Syndromic Conundrums in Diabetes: Seek and Ye Shall Find: The Dorfman-Chanarin Syndrome
Show more Case Studies

Similar Articles

Navigate

  • Current Issue
  • Papers in Press
  • Abridged Standards of Care
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes
  • Diabetes Care
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Clinical Diabetes Print ISSN: 0891-8929, Online ISSN: 1945-4953.