Skip to main content
Top
Published in: Nutrition Journal 1/2015

Open Access 01-12-2015 | Case Report

Ketoacidosis in a non-diabetic woman who was fasting during lactation

Authors: Sarah K. Hudak, Dietrich Overkamp, Robert Wagner, Hans-Ulrich Häring, Martin Heni

Published in: Nutrition Journal | Issue 1/2015

Login to get access

Abstract

Ketoacidosis is a potential complication of type 1 diabetes. Severe ketoacidosis with a blood pH below 7.0 is only rarely seen in other diseases.
Three weeks after delivery, a young woman was admitted because of tachypnoe and tachycardia. Blood gas analysis showed a severe metabolic acidosis with a high anion gap. Further workup revealed the presence of ketone bodies in the urine with normal blood glucose and no history of diabetes. The patient reported that she had not eaten for days because of abdominal pain. After initial treatment in the ICU and immediate re-feeding, the patient’s condition rapidly improved.
While under normal circumstances fasting causes at most only mild acidosis, it can be dangerous during lactation. Prolonged fasting in combination with different forms of stress puts breast feeding women at risk for starvation ketoacidosis and should therefore be avoided.
Literature
2.
go back to reference Kamel KS, Halperin ML. Acid–base problems in diabetic ketoacidosis. N Engl J Med. 2015;372:546–54.CrossRefPubMed Kamel KS, Halperin ML. Acid–base problems in diabetic ketoacidosis. N Engl J Med. 2015;372:546–54.CrossRefPubMed
3.
go back to reference Mohammad MA, Sunehag AL, Chacko SK, Pontius AS, Maningat PD, Haymond MW. Mechanisms to conserve glucose in lactating women during a 42-h fast. Am J Physiol Endocrinol Metab. 2009;297:E879–888.CrossRefPubMedPubMedCentral Mohammad MA, Sunehag AL, Chacko SK, Pontius AS, Maningat PD, Haymond MW. Mechanisms to conserve glucose in lactating women during a 42-h fast. Am J Physiol Endocrinol Metab. 2009;297:E879–888.CrossRefPubMedPubMedCentral
4.
go back to reference Chernow B, Finton C, Rainey TG, O’Brian JT. “Bovine ketosis” in a nondiabetic postpartum woman. Diabetes Care. 1982;5:47–9.CrossRefPubMed Chernow B, Finton C, Rainey TG, O’Brian JT. “Bovine ketosis” in a nondiabetic postpartum woman. Diabetes Care. 1982;5:47–9.CrossRefPubMed
5.
go back to reference Heffner AC, Johnson DP. A case of lactation “bovine” ketoacidosis. J Emerg Med. 2008;35:385–7.CrossRefPubMed Heffner AC, Johnson DP. A case of lactation “bovine” ketoacidosis. J Emerg Med. 2008;35:385–7.CrossRefPubMed
6.
go back to reference Goff JP. Major advances in our understanding of nutritional influences on bovine health. J Dairy Sci. 2006;89:1292–301.CrossRefPubMed Goff JP. Major advances in our understanding of nutritional influences on bovine health. J Dairy Sci. 2006;89:1292–301.CrossRefPubMed
7.
go back to reference Szulewski A, Howes D, Morton AR: A severe case of iatrogenic lactation ketoacidosis. Case Rep 2012, 2012:bcr1220115409–bcr1220115409. Szulewski A, Howes D, Morton AR: A severe case of iatrogenic lactation ketoacidosis. Case Rep 2012, 2012:bcr1220115409–bcr1220115409.
8.
go back to reference Mahoney CA. Extreme gestational starvation ketoacidosis: case report and review of pathophysiology. Am J Kidney Dis Off J Natl Kidney Found. 1992;20:276–80.CrossRef Mahoney CA. Extreme gestational starvation ketoacidosis: case report and review of pathophysiology. Am J Kidney Dis Off J Natl Kidney Found. 1992;20:276–80.CrossRef
9.
go back to reference Altus P, Hickman JW. Severe spontaneous “bovine” ketoacidosis in a lactating woman. J Indiana State Med Assoc. 1983;76:392–3.PubMed Altus P, Hickman JW. Severe spontaneous “bovine” ketoacidosis in a lactating woman. J Indiana State Med Assoc. 1983;76:392–3.PubMed
Metadata
Title
Ketoacidosis in a non-diabetic woman who was fasting during lactation
Authors
Sarah K. Hudak
Dietrich Overkamp
Robert Wagner
Hans-Ulrich Häring
Martin Heni
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Nutrition Journal / Issue 1/2015
Electronic ISSN: 1475-2891
DOI
https://doi.org/10.1186/s12937-015-0076-2

Other articles of this Issue 1/2015

Nutrition Journal 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine