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CC BY 4.0 · Journal of Diabetes and Endocrine Practice
DOI: 10.1055/s-0045-1802639
Case Report

Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State as the First Presentation of Acromegaly: Case Report and Literature Review

Shamma Alshamsi
1   Division of Endocrinology, Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
,
Hour AlSheleh
2   Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
,
Raya Almazrouei 
1   Division of Endocrinology, Department of Internal Medicine, Tawam Hospital, Al Ain, United Arab Emirates
3   Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Abstract

Acromegaly is characterized by excessive growth hormone secretion and is usually associated with glucose intolerance or diabetes mellitus. It is rare to be associated with life-threatening diabetes emergencies. Here, we present a case of a 38-year-old woman who initially presented with a severe hyperglycemia crisis that meets the criteria for both diabetes ketoacidosis and hyperosmolar hyperglycemic state. Subsequently, she was found to exhibit signs of typical acromegaly, including enlargement of hands, thick skin, and interdental spacing. The diagnosis was established based on typical clinical manifestations, hormonal assays, and radiological findings confirming pituitary macroadenoma. Timely identification and diagnosis are crucial for mitigating the potential complications associated with this condition.

Keywords

diabetic ketoacidosis - acromegaly - hyperosmolar hyperglycemic state - pituitary adenomas

Patient Consent Statement

Verbal informed consent was obtained from the patient for publication of this case report.


Authors' Contributions

All authors were involved in data collection, manuscript drafting, and finalizing. S.H. and H.A. collected the data. S.H. and R.A. were involved in intellectual input and performed manuscript writing, editing, and review. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.


Compliance with Ethical Principles

No ethical approval is required for single case report.


Availability of Data and Material

For confidentiality reasons, the original data cannot be shared.




Publication History

Article published online:
11 March 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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