Case Report|Articles in Press, 104501

Complicated Acidosis Presentations: When Is Diabetic Ketoacidosis Not Diabetic Ketoacidosis? A Case Series

Published:December 12, 2022DOI:


      • We present the pathophysiology, clinical presentations, and management considerations for ketoacidosis related to sodium-glucose cotransporter 2 inhibitors, pregnancy, fasting, and alcoholic acidosis.


      Diabetic ketoacidosis (DKA) is a common and generally well-understood medical condition in urgent and acute care centers. There are numerous conditions that have similar presentations to DKA but are better served with different treatment modalities. This article discusses the clinical presentation, diagnostic criteria, and management pearls of euglycemic DKA, alcoholic acidosis, fasting ketosis, and ketosis of pregnancy to help the reader more clearly distinguish between conditions to optimize patient care and outcomes.


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      Elizabeth Bell-McClure, DNP, FNP is a clinical associate at Duke University School of Nursing in Durham, NC, and can be contacted at [email protected]


      Valerie Sabol, PhD, ACNP-BC, GNP-BC, CNE is a professor at Duke University School of Nursing.


      Kristen McMillan, MSN, FNP-C ia an NP at Duke University Medical Center, Durham, NC.