Severe Ketoacidosis Complicated by ‘Ecstasy’ Ingestion and Prolonged Exercise

Abstract

Ecstasy (3,4‐methylenedioxymethamphetamine or MDMA) is used with increasing frequency as a recreational drug. Accumulated evidence over recent years indicates a growing demand for the drug with a corresponding increase in number of reports of adverse effects from its use. There are reported metabolic disturbances due to MDMA use. These, in addition to the prolonged exercise involved in dancing at ‘raves’ where MDMA may be used, may exacerbate ketoacidosis. We report two cases of ketoacidosis complicated by MDMA ingestion.

Substance abuse in young patients with type 1 diabetes: easily neglected in complex medical management

“…Ecstasy and ketamine, particularly in combination, can result in marked hyponatraemia in ketoacidosis 2 , and serum sodium should be carefully monitored when concurrent drug use is suspected. Ketamine may cause agitation, hypertension, tachycardia and hyperthermia, with the danger of acidosis and rhabdomyolysis in severe intoxication 3 .…”

Links between Nutrition, Drug Abuse, and the Metabolic Syndrome

“…A study in the United Kingdom indicated that street drug use in young adults with diabetes may contribute to poor glycemic control and serious complications of diabetes 24 . The metabolic disturbances such as diabetic ketoacidosis and poor glycemic control may be further exacerbated by MDMA abuse during prolonged exercise 25 …”

Diabetic ketoacidosis complicated by the use of ecstasy: a case report

“…Both were insulin-dependent diabetics and ingested ecstasy during a rave party, during which they danced strenuously. They showed good clinical evolution after fluid replacement and the administration of insulin, although one of the patients developed bronchopneumonia and needed intubation and mechanical ventilation [11]. …”