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To the Editor: We read with great pleasure the article by Sharayah et al about acute gastro­paresis in a patient with diabetic ketoacidosis.1 However, in the case description, the authors reached a diagnosis of gastroparesis secondary to diabetic ketoacidosis without aptly ruling out some of its most common causes such as hypokalemia and other electrolyte imbalances seen in diabetic patients (in the setting of recurrent vomiting).

The authors also did not include the patient’s duration of diabetes or hemoglobin A1c level, both of which are linked with gastroparesis in diabetic patients.2 Pertinent biochemical information that can help readers formulate a rational approach and journey to making a diagnosis appears elusive in their article.

References
  1. Sharayah AM, Hajjaj N, Osman R, Livornese D. Gastroparesis in a patient with diabetic ketoacidosis. Cleve Clin J Med 2019; 86(4):238–239. doi:10.3949/ccjm.86a.18116
  2. Bharucha AE, Kudva Y, Basu A, et al. Relationship between glycemic control and gastric emptying in poorly controlled type 2 diabetes. Clin Gastroenterol Hepatol 2015; 13(3):466–476.e461. doi:10.1016/j.cgh.2014.06.034
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Amos Lal, MD
Saint Vincent Hospital, Worcester, MA

Pantea Ebrahimpour, MD
Saint Vincent Hospital, Worcester, MA

Nitin Trivedi, MD, FACP, FACE
Saint Vincent Hospital, Worcester, MA

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Cleveland Clinic Journal of Medicine - 86(8)
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gastroparesis, diabetes, diabetic ketoacidosis, Amos Lal, Pantea Ebrahimpour, Nitin Trivedi, ahmad Sharayah, Noor Hajaj, Ramy Osman, Douglas Livornese
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Amos Lal, MD
Saint Vincent Hospital, Worcester, MA

Pantea Ebrahimpour, MD
Saint Vincent Hospital, Worcester, MA

Nitin Trivedi, MD, FACP, FACE
Saint Vincent Hospital, Worcester, MA

Author and Disclosure Information

Amos Lal, MD
Saint Vincent Hospital, Worcester, MA

Pantea Ebrahimpour, MD
Saint Vincent Hospital, Worcester, MA

Nitin Trivedi, MD, FACP, FACE
Saint Vincent Hospital, Worcester, MA

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To the Editor: We read with great pleasure the article by Sharayah et al about acute gastro­paresis in a patient with diabetic ketoacidosis.1 However, in the case description, the authors reached a diagnosis of gastroparesis secondary to diabetic ketoacidosis without aptly ruling out some of its most common causes such as hypokalemia and other electrolyte imbalances seen in diabetic patients (in the setting of recurrent vomiting).

The authors also did not include the patient’s duration of diabetes or hemoglobin A1c level, both of which are linked with gastroparesis in diabetic patients.2 Pertinent biochemical information that can help readers formulate a rational approach and journey to making a diagnosis appears elusive in their article.

To the Editor: We read with great pleasure the article by Sharayah et al about acute gastro­paresis in a patient with diabetic ketoacidosis.1 However, in the case description, the authors reached a diagnosis of gastroparesis secondary to diabetic ketoacidosis without aptly ruling out some of its most common causes such as hypokalemia and other electrolyte imbalances seen in diabetic patients (in the setting of recurrent vomiting).

The authors also did not include the patient’s duration of diabetes or hemoglobin A1c level, both of which are linked with gastroparesis in diabetic patients.2 Pertinent biochemical information that can help readers formulate a rational approach and journey to making a diagnosis appears elusive in their article.

References
  1. Sharayah AM, Hajjaj N, Osman R, Livornese D. Gastroparesis in a patient with diabetic ketoacidosis. Cleve Clin J Med 2019; 86(4):238–239. doi:10.3949/ccjm.86a.18116
  2. Bharucha AE, Kudva Y, Basu A, et al. Relationship between glycemic control and gastric emptying in poorly controlled type 2 diabetes. Clin Gastroenterol Hepatol 2015; 13(3):466–476.e461. doi:10.1016/j.cgh.2014.06.034
References
  1. Sharayah AM, Hajjaj N, Osman R, Livornese D. Gastroparesis in a patient with diabetic ketoacidosis. Cleve Clin J Med 2019; 86(4):238–239. doi:10.3949/ccjm.86a.18116
  2. Bharucha AE, Kudva Y, Basu A, et al. Relationship between glycemic control and gastric emptying in poorly controlled type 2 diabetes. Clin Gastroenterol Hepatol 2015; 13(3):466–476.e461. doi:10.1016/j.cgh.2014.06.034
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Cleveland Clinic Journal of Medicine - 86(8)
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Cleveland Clinic Journal of Medicine - 86(8)
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gastroparesis, diabetes, diabetic ketoacidosis, Amos Lal, Pantea Ebrahimpour, Nitin Trivedi, ahmad Sharayah, Noor Hajaj, Ramy Osman, Douglas Livornese
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