Successful Treatment of Diabetic Ketoacidosis in a Patient with Insulin Allergy and Coronavirus Disease 2019: A Case Report

Abstract

Diabetic ketoacidosis is a frequent hyperglycemic emergency. During the coronavirus disease 2019 pandemic, researchers showed a higher prevalence of diabetic ketoacidosis and mortality compared with the preceding years. It is expected that lung involvement in coronavirus disease 2019 decreases compensation capacity for ketoacidosis. Thus, management of the diabetic keto-acidosis is critical in patients with coronavirus disease 2019. Insulin allergy makes the treatment procedure more complicated in these patients. Desensitization procedures or immunomodulatory therapies are not a routine part of treating diabetic ketoacidosis due to the urgency of the disease. Insulin administration to patients with insulin allergy and coronavirus disease 2019 may cause a risk of decreased maintaining oxygenation and compensating for ketoacidosis and endanger airway safety due to possible anaphylaxis. Clinicians should check all preparations for a possible need for anaphylaxis treatment and difficult airway management, including invasive procedures before insulin therapy. Here, we wanted to share a case of successful treatment of diabetic ketoacidosis in a patient with insulin allergy and coronavirus disease 2019.