Abstract
A 59-year-old man with diabetes arrived at our hospital by ambulance. His conscious state was poor and systolic blood pressure 60 mm Hg. The patient underwent tracheal intubation and was transferred to the intensive care unit. Diabetic ketoacidosis was diagnosed based on the patient's history and laboratory data. Fluid resuscitation and vasopressors improved his blood pressure and conscious state within 3 h of admission, and the tracheal tube was removed. Treatment with an artificial pancreas (STG-55; Nikisso, Tokyo, Japan) was initiated 4 h after admission to manage the patient's hyperglycemia. We set the target blood glucose level frequently because the rate of blood glucose decline was <100 mg/dL/hr. The patient's hemodynamics, respiratory rate, and blood glucose level (~250 mg/dL) stabilized by the next morning, and he was transferred to the general ward. An artificial pancreas provided optimal blood glucose management without hypoglycemia for a patient experiencing diabetic ketoacidosis and could thus be a useful insulin therapy to control blood glucose levels.
