Non-diabetic ketoacidosis associated with a low carbohydrate, high fat diet in a postpartum lactating female
Open accessAbstract
A 31-year old non-diabetic woman presented to our hospital with symptoms of dehydration, drowsiness, fatigue, shortness of breath and vomiting present for two consecutive days prior to admission. She had started a low carbohydrate, high fat (LCHF) diet to induce weight loss while breastfeeding her 4-month-old child 2 weeks prior to admission. The patient was found to have a severely high anion gap metabolic acidosis. It was determined to be due to ketoacidosis, which was as a result of carbohydrate restriction in the presence of increased metabolic demands related with the synthesis and secretion of milk. She denied alcohol use or ingestion of any drugs prior to admission. The patient underwent dialysis and received insulin, 5% dextrose water alongside a well-balanced diet with adequate calories. All abnormal laboratory results normalized and follow-up visits were done. Lactating women are at risk of developing ketoacidosis due to high metabolic demands of the body to produce milk. LCHF diets may exacerbate the body’s demand to meet its milk production requirement and result in ketoacidosis. Health professionals need to be aware of the complications of LCHF diet in this population to prevent mortality associated with this condition.
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Metabolic ketoacidosis with ketogenic diets is a hazard, particularly with sodium−glucose cotransporter 2 (SGLT2) inhibitors.
“Metabolic ketoacidosis with ketogenic diets is a hazard, particularly with sodium−glucose cotransporter 2 (SGLT2) inhibitors [82–87].”
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- Authors
- Marzban, S., Arbee, M., Vorajee, N., & Richards, G. A.
- Affiliations
- Clinical Pharmacy, Netcare Christiaan Barnard Memorial Hospital, Cape Town, South Africa
- Clinical Haematology, Netcare Garden City Hospital, Johannesburg, Gauteng, South Africa
- National Health Laboratory Service (ZA)
- University of the Witwatersrand (ZA)
- Corresponding author
- Marzban, Saba
- ORCID
- Richards, Guy A
- Venue
- Oxford Medical Case Reports
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-08-01
- Volume
- 2020
- Issue
- 8
- Pages
- omz026-omz026
- ISSN
- 2053-8855 (ISSN-L)
- PMC
- PMC7416821
- OpenAlex
- W3048769077
- Cited by
- 10
- References
- 18
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Oxford Medical Case Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- low-carbohydrate high-fat diet, ketogenic diet, lactation, postpartum women, anion gap metabolic acidosis, weight loss diet, dialysis, insulin therapy
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