Abstract
A patient presenting with diabetic ketoacidosis and diabetes insipidus was found to have acromegaly. This is an unusual presentation of a rare condition and highlights the need for broad diagnostic skills in intensive care medicine in order to institute effective treatment. Diabetic ketoacidosis is a common reason for admission to hospital and is associated with increased morbidity and mortality. It is likely that an increasing proportion of patients will be admitted to intensive care in view of current guidelines for the management of sever diabetic ketoacidosis. One of the secondary causes of diabetes is acromegaly. This is a rare condition, often associated with a delay from the onset of symptoms to diagnosis, and diabetes is an uncommon presentation. This patient presented with features of both diabetes mellitus and diabetes insipidus, both associated with acromegaly.