March 3, 2026Open Access

Diabetic ketoacidosis as the initial presentation of hepatogenous diabetes: a first reported case

Key Points

Diabetic ketoacidosis can occur as the first sign of hepatogenous diabetes, indicating a need for awareness in cirrhotic patients.
Even with normal HbA1C levels, DKA may present in patients without a diabetes history, complicating diagnosis.
Oral glucose tolerance testing is recommended when hepatogenous diabetes is suspected, despite normal glycemic markers.
Subclinical infections can trigger insulin resistance, contributing to diabetic ketoacidosis in cirrhosis.

Abstract

DKA can be the first clinical manifestation of hepatogenous diabetes, even in patients with normal HbA1C and no prior diabetes history. HbA1C is an unreliable marker for diagnosing diabetes in cirrhotic patients due to shortened red blood cell lifespan; OGTT should be considered when hepatogenous diabetes is suspected despite normal glycemic markers. Subclinical infections can precipitate DKA in cirrhosis through stress-induced insulin resistance.

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Authors

Mhd Kutaiba Albuni

Shahem Abbarh

Noheir Ashraf Ibrahem Fathy Hassan

Journals

Endocrinology Diabetes and Metabolism Case Reports

Actions

Institutions

Georgetown University

Qatar University

Southern Illinois University School of Medicine

References and Citations

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Building similarity graph...

Analyzing shared references across papers

Diabetic ketoacidosis as the initial presentation of hepatogenous diabetes: a first reported case

Key Points

Abstract

Citation Network

Connected Papers

Discussion

Authors

Journals

Actions

Institutions

References and Citations

Citation Network

Connected Papers

Discussion

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