Type 1 diabetes mellitus presenting as distal renal tubular acidosis (type 1)

Ravi Kant, Mohit Garg, Mahendra Kumar Meena


A 42 year-old male patient known case of type 1 diabetes mellitus for last 15 years got admitted with bilateral lower limb swelling and poorly controlled diabetes. He was found to have alkaline urinary pH, persistent metabolic acidosis even after the correction of blood sugars without ketonuria or diabetic ketoacidosis and nephrocalcinosis thus he was diagnosed as distal renal tubular acidosis (RTA Type 1) and managed by alkali replacement with blood sugar control. The association of type-1 diabetes mellitus with type-1 RTA has been rarely reported in the literature, but there are various case reports which had linked with distal RTA with autoimmunity and destruction of DCT. As our case which was unusual as every type-1 diabetes doesn’t have acidosis due to DKA focused research is required in this field.  


Type 1 diabetes mellitus, Ketonuria, Distal renal tubular acidosis, Diabetic ketoacidosis, Nephrocalcinosis

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