American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2020, 8(10), 335-336
DOI: 10.12691/ajmcr-8-10-4
Open AccessCase Report

Severe Euglycemic Ketoacidosis Induced by Ketogenic Diet

Sana Ahmad1 and Jacob Schwartz1,

1Lenox Hill Hospital, Department of internal Medicine New York, NY

Pub. Date: June 18, 2020

Cite this paper:
Sana Ahmad and Jacob Schwartz. Severe Euglycemic Ketoacidosis Induced by Ketogenic Diet. American Journal of Medical Case Reports. 2020; 8(10):335-336. doi: 10.12691/ajmcr-8-10-4


Ketogenic diets are diets based on restricted carbohydrate intake in favor of foods high in protein, fats, and fiber. As a result, blood sugar levels tend to drop. This process ultimately leads to the production of ketones which are then used by the body for fuel resulting in ketonemia. This case report focuses on a non-obese male with no past medical history who presented with several days of nausea and vomiting after recently starting himself on a ketogenic diet. Upon admission, the patient was found to have an increased anion gap metabolic acidosis with a gap of 37. Secondary causes of elevated anion gap metabolic acidosis were ruled out. The patient was appropriately fluid resuscitated with a dextrose containing fluid with improvement in symptoms and closure of the gap. Underlying hepatic steatosis may contribute to the development of euglycemic ketoacidosis in those on a low carbohydrate diet. A minimum amount of carbohydrates (approximately 100 grams) may prevent ketosis in these patients. It is important for providers to understand and recognize that severe euglycemic ketoacidosis can be a complication of a ketogenic diet.

Euglycemic ketoacidosis ketogenic diet increased anion gap metabolic acidosis. Ketonemia

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