Endocrine Abstracts

JOINT3873

Background: Diabetes Mellitus Type 2 (T2DM) is commonly associated with various complications, including cardiovascular, renal, and hepatic dysfunction. Diabetic ketoacidosis (DKA) is a potentially fatal endocrine emergency resulting from uncontrolled diabetes mellitus (DM). We present a case of a T2DM patient who presented in an emergency setting with severe diabetic ketoacidosis and multiple organ failure.

Case Presentation: A 51-year-old male with a history of poorly controlled T2DM in treatment with basal -bolus insulin presented to the emergency department with symptoms of altered consciousness, abdominal pain, and general fatigue. On admission, the patient exhibited severe metabolic acidosis (pH 6.9), elevated serum amylase (550 U/l), lipase (510 U/l), creatine kinase-MB (CK-MB) (80 U/l), and troponin I (0.15 ng/mL) Laboratory findings also revealed significantly elevated liver enzymes (AST, ALT) and renal dysfunction (elevated serum creatinine and urea). Clinical examination suggested signs of multiple organ failure, including hepatic, renal, pancreatitis and cardiac involvement.

Management and Outcome: Initial management focused on correction of ketoacidosis and stabilization of the patient’s cardiovascular, renal, and hepatic functions. The patient was treated with intravenous fluids, insulin for blood glucose control and intensive monitoring of organ functions. The patient’s clinical condition improved gradually, with normalization of metabolic parameters, organ function, and consciousness over the course of 24-48 hours.

Conclusions: This case highlights the complexity of managing T2DM patients with severe acidosis and multi-organ failure. Acute complications like diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) can lead to multi organ dysfunction if not promptly recognized and managed. Early intervention and multi-disciplinary management are critical in improving outcomes in such high-risk patients.