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Diabetic Ketoacidosis in Type 2 Diabetics: A Novel Presentation of Pancreatic Adenocarcinoma

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Abstract

Diabetic ketoacidosis (DKA) has been the hallmark of a life-threatening medical emergency for poorly controlled or newly diagnosed type 1 diabetics. In the last two decades, this traditional association has been challenged with increasing reports of type 2 diabetics presenting with DKA. We report the case of a 75-year-old woman with known type 2 diabetes who presented in DKA and was found to have pancreatic adenocarcinoma. A link between diabetes mellitus and pancreatic cancer has been investigated, but the literature remains inconclusive as to whether diabetes mellitus (DM) is a cause or result of pancreatic cancer or simply the confluence of two common entities. Previous case reports of pancreatic tumors presenting with DKA all represented neuroendocrine tumors. Adenocarcinoma of the pancreas should be considered in the list of precipitants for DKA in type 2 DM.

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Acknowledgments

We thank the patient’s family for their consent to allow us to use this case for teaching. We also thank Dennis Policastro, MD and Mindi Roeser, MD for advice and assistance, Michiko Riko Nagamine, MD for providing the pathology slides and Steve Bieko, MD for the CT images.

There was no funding associated with the manuscript preparation.

Conflict of Interest

None disclosed.

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Authors and Affiliations

  1. Department of Internal Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, 800 Spruce Street, 1 Pine West, Philadelphia, PA, 19107, USA

    Ming Valerie Lin MD & Gene Bishop MD

  2. Department of Endocrinology, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA

    Maria Benito-Herrero MD

Authors
  1. Ming Valerie Lin MD
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  2. Gene Bishop MD
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  3. Maria Benito-Herrero MD
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Correspondence to Ming Valerie Lin MD.

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Lin, M.V., Bishop, G. & Benito-Herrero, M. Diabetic Ketoacidosis in Type 2 Diabetics: A Novel Presentation of Pancreatic Adenocarcinoma. J GEN INTERN MED 25, 369–373 (2010). https://doi.org/10.1007/s11606-009-1237-9

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  • DOI: https://doi.org/10.1007/s11606-009-1237-9

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