Abstract
We report a 35-year-old man with early-onset diabetes who experienced cardiac arrest due to concurrent diabetic ketoacidosis (DKA). The patient had been managed on oral medication for type 2 diabetes. He had general malaise and asked a neighborhood physician to make a house call. As he lost consciousness during the examination, he was transported to the emergency department of our hospital. Despite cardiac arrest after arrival, spontaneous circulation was restored after 31 minutes of cardiopulmonary resuscitation and he was admitted to the ICU. At the time of ICU admission, he had marked hyperkalemia, hyponatremia, and hyperglycemia as well as hemoconcentration due to osmotic diuresis. Blood sugar and electrolyte corrections, as well as circulatory control, while conducting mild hypothermia therapy, achieved improvement and the patient was discharged from the ICU on day 13. Although type 2 diabetes is basically ketosis resistant, it was assumed that drinking large quantities of soft drinks had induced so-called soft drink ketosis, which is accompanied by acidosis and the induction of hyperkalemia, ultimately resulting in cardiac arrest.
