Diabetic Ketoacidosis commonly presents with hyponatremia, but hypernatremia is a rare entity. We report a unique case\nof a 50-year-old woman admitted with altered sensorium with blood glucose 979 milligrams/deciliter, serum osmolarity 363\nmOsm/kilograms, and serum sodium 144 milliequivalents/liter. Patient was given initial bolus of isotonic saline and continued\non half isotonic saline for correction of hypernatremia along with insulin infusion therapy. Patient was successfully treated with\nintravenous fluids, insulin infusion, and the altered sensorium was resolved without any sequelae. This case illustrates a teaching\npoint in the use of intravenous fluids for the treatment of Diabetic Ketoacidosis with hypernatremia.
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