Diabetic ketoacidosis with alkalemia

Abstract

A case of diabetic ketoacidosis presenting with alkalemia (pH, 7.61) instead of acidemia (pH < 7.35) is discussed. Severe vomiting results in electrolyte depletion and hypovolemia, which in turn results in bicarbonate reabsorption and an alkalemic state despite the presence of ketoncids. Severe respiratory alkalosis can also result in alkalemia. Recognition of the alkalemia and its cause will lead to the institution of appropriate therapy.