Severe ketoacidosis in a non-diabetic lactating woman on a ketogenic diet
Keywords:diabetes mellitus, ketosis, ketoacidosis, ketogenic diet, non-diabetic ketoacidosis
Ketogenic diets are high fat, moderate protein, low carbohydrate diets with carbohydrate content usually less than 50 g/day. They are a novel intervention in the management of obesity and there is emerging evidence that they are very effective. Evidence regarding the long-term efficacy and safety of this rather new and popular intervention is still emerging and there is a lack of data on the effect of this diet in specific populations such as breast feeding women. We describe a case of severe ketoacidosis in a non-diabetic breast feeding woman who was successfully treated with conservative measures. This case highlights the need by medical and dietetic professionals for extra caution in initiating special dietary measures in susceptible physiological states.
Gleeson S. Lactation ketoacidosis: an unusual entity and a review of the literature. Perm J 2016;20(1):71–3. https://doi.org/10.7812/TPP/15-097
Holtenius P, Holtenius K. New aspects of ketone bodies in energy metabolism of dairy cows: a review. Zentralbl Veterinarmed A 1996;43(1–10):579–87. https://doi.org/10.1111/j.1439-0442.1996.tb00491.x
von Geijer L, Ekelund M. Ketoacidosis associated with low-carbohydrate diet in a non-diabetic lactating woman: a case report. J Med Case Rep 2015;9:224. https://doi.org/10.1186/s13256-015-0709-2
Nnodum B, Oduah E, Albert D, Pettus M. Ketogenic diet-induced severe ketoacidosis in a lactating woman: a case report and review of the literature. Case Rep Nephrol 2019;2019:1214208. https://doi.org/10.1155/2019/1214208
Basnet S, Tachamo N, Nazir S, Dhital R, Jehangir A, Donato A. Severe anion gap metabolic acidosis associated with initiation of a very low-carbohydrate diet. J Community Hosp Intern Med Perspect 2019; 9(2):165–7. https://doi.org/10.1080/20009666.2019.1583534
Vining E. A multicenter study of the efficacy of the ketogenic diet. Arch Neurol 1998;55(11):1433–7. https://doi.org/10.1001/archneur.55.11.1433
Paoli A, Rubini A, Volek J, Grimaldi K. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr 2013;67(8):789–96. https://doi.org/10.1038/ejcn.2013.116
Gomez-Arbelaez D, Crujeiras A, Castro A, et al. Acid–base safety during the course of a very low-calorie-ketogenic diet. Endocrine 2017; 58(1):81–90. https://doi.org/10.1007/s12020-017-1405-3
Yancy W, Olsen M, Dudley T, Westman E. Acid-base analysis of individuals following two weight loss diets. Eur J Clin Nutr 2007;61(12):1416–22. https://doi.org/10.1038/sj.ejcn.1602661
Barski L, Eshkoli T, Brandstaetter E, Jotkowitz A. Euglycemic diabetic ketoacidosis. Eur J Intern Med 2019;63:9–14. https://doi.org/10.1016/j.ejim.2019.03.014
Publish & Transfer of Copyright Agreement
For the mutual benefit and protection of the Author and the Journal Owner/Publisher it is necessary that the Author provides formal written Consent to Publish and Transfer of Copyright before publication of the Work.