Acromegaly presenting with diabetic ketoacidosis

The case of a 30‐year‐old woman presenting with diabetic ketoacidosis as a first manifestation of acromegaly is reported. This is an extremely rare and unusual presentation. The case illustrates the importance of insulin resistance due to growth hormone excess in the presence of relative insulin deficiency as a cause of diabetic ketoacidosis. Copyright © 2004 John Wiley & Sons, Ltd.