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<p>Diabetic ketoacidosis (DKA) is an uncommon but serious complication in patients with type 2 diabetes mellitus (T2DM). Excessive intake of sugar-sweetened beverages (SSBs) may represent an underrecognized trigger for DKA in individuals with T2DM. We present two male patients with T2DM who developed ketosis following excessive consumption of SSBs (aerated drinks). The first patient, aged 33 years, reported consuming 2.5 litre/day of SSBs and developed ketosis without acidosis. The second, aged 18 years, reported daily intake of 4 litre/day of SSBs and presented with frank DKA. Both patients were managed with insulin therapy, which was successfully tapered off post-discharge. At follow-up, glycemic control was maintained with oral antidiabetic therapy or lifestyle modification alone. Both patients exhibited clinical signs of insulin resistance and were negative for anti-glutamic acid decarboxylase antibodies. These cases underscore the potential role of SSBs in precipitating ketosis in T2DM patients.</p>

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Sugar-sweetened beverages and acute metabolic crises in type 2 diabetes mellitus: a report of two cases

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Abhinay Jain,
  • Ankitesh Kumar,
  • Pooja Alipuria,
  • Pragya Mangla,
  • Nishant Raizada,
  • S. V. Madhu

摘要

Diabetic ketoacidosis (DKA) is an uncommon but serious complication in patients with type 2 diabetes mellitus (T2DM). Excessive intake of sugar-sweetened beverages (SSBs) may represent an underrecognized trigger for DKA in individuals with T2DM. We present two male patients with T2DM who developed ketosis following excessive consumption of SSBs (aerated drinks). The first patient, aged 33 years, reported consuming 2.5 litre/day of SSBs and developed ketosis without acidosis. The second, aged 18 years, reported daily intake of 4 litre/day of SSBs and presented with frank DKA. Both patients were managed with insulin therapy, which was successfully tapered off post-discharge. At follow-up, glycemic control was maintained with oral antidiabetic therapy or lifestyle modification alone. Both patients exhibited clinical signs of insulin resistance and were negative for anti-glutamic acid decarboxylase antibodies. These cases underscore the potential role of SSBs in precipitating ketosis in T2DM patients.