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Article

Severe Euglycemic Ketoacidosis Induced by Ketogenic Diet

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


American Journal of Medical Case Reports. 2020, Vol. 8 No. 10, 335-336
DOI: 10.12691/ajmcr-8-10-4
Copyright © 2020 Science and Education Publishing

Cite this paper:
Sana Ahmad, 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.

Correspondence to: Jacob  Schwartz, Lenox Hill Hospital, Department of internal Medicine New York, NY. Email: Jakeschwartz89@gmail.com

Abstract

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.

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