Analysis of Clinical Misdiagnosis of Diabetic Ketoacidosis
TAO Yahui
FANG Shenghui
LI Wenhui
Abstract：Objective To analyze the causes of misdiagnosis of diabetic ketoacidosis(DKA),so as to improve the vigilance and diagnostic accuracy of clinicians.Methods The clinical data of 3 DKA patients initially diagnosed with other diseases from 2020 to 2023 were retrospectively analyzed.Results One patient initially presented with severe upper abdomi-nal pain,nausea and vomiting,and was considered to have acute pancreatitis by laboratory examination.The main symptoms of 1 patient were abdominal distension,abdominal pain and constipation,with initial diagnosis of intestinal obstruction.One patient presented with sudden headache and disturbance of consciousness and was initially diagnosed with acute cerebrovascu-lar accident.After relevant treatment,the condition of the 3 patients did not improve significantly.Further examinations,in-cluding blood glucose,urinary ketone body and arterial blood gas analysis,showed significant increase in blood glucose,strong positive urinary ketone body,and arterial blood gas analysis showed metabolic acidosis;all were diagnosed with DKA.The duration of misdiagnosis was 1-4 d.After diagnosis,all the 3 patients received insulin and rehydration therapy,and their conditions were significantly improved with a good prognosis.Conclusion The clinical manifestations of DKA are diverse and lack specificity,which is more likely to be confused with other emergencies.Early blood glucose,urinary ketone body and ar-terial blood gas analysis should be performed as early as possible in order to timely identify and diagnose DKA and avoid ad-verse consequences caused by misdiagnosis.
Keywords：Diabetes mellitusKetoacidosisMisdiagnosisPancreatitisIntestinal obstructionCerebrovascular ac-cidentBlood SugarUrinary ketone bodiesArterial blood gas analysis
Publication Date：2024-09-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 10-13 )