Catamenial diabetic ketoacidosis—a diagnostic dilemma in ED

Diabetic ketoacidosis (DKA) is a frequent medical emergency. The most common precipitating events are absolute or relative deficiency of insulin, infection, and noncompliance with medication. We describe a 32-year-old lady with type 1 diabetes mellitus in whom DKA was precipitated 1 to 2 days before her menstrual periods resulting in repeated admissions to hospital. Menstruation may precipitate DKA. Emergency physicians must keep this in mind if no other precipitating event can be found in a patient with DKA.

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