Charoensri Suranut, Sothornwit Jin, Trirattanapikul Akeatit, Pongchaiyakul Chatlert
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Case Rep Endocrinol. 2021 Feb 8;2021:6620832. doi: 10.1155/2021/6620832. eCollection 2021.
Ketogenic diet, a very low-carbohydrate diet and high-fat diet, has emerged as a popular approach for weight reduction, particularly in young adults. However, a serious but rare complication of the ketogenic diet is ketoacidosis associated with low carbohydrate intake, which should be cautiously monitored in people with a predisposition to the condition. We report a 22-year-old Thai woman with an unremarkable past medical history who presented with an acute onset of dyspnea of 2 days' duration. Diabetic ketoacidosis was diagnosed by elevated capillary blood glucose, significant metabolic acidosis, and a high serum beta-hydroxybutyrate level. Low C-peptide level and positive islet autoantibodies confirmed the new diagnosis of type 1 diabetes in this patient. After her conditions were stabilized, the patient revealed that she began a ketogenic diet for weight reduction 4 days before her illness. Other precipitating factors were not identified. This highlights that ketogenic diet may increase diabetic ketoacidosis risk at the presentation of previously unrecognized type 1 diabetes.
生酮饮食是一种碳水化合物含量极低而脂肪含量高的饮食方式，已成为一种流行的减肥方法，尤其在年轻人中。然而，生酮饮食一种严重但罕见的并发症是与低碳水化合物摄入相关的酮症酸中毒，对于易患此病的人群应谨慎监测。我们报告一名22岁的泰国女性，既往病史无异常，出现了持续2天的急性呼吸困难。通过毛细血管血糖升高、明显的代谢性酸中毒和高血清β-羟基丁酸水平诊断为糖尿病酮症酸中毒。低C肽水平和胰岛自身抗体阳性证实该患者新诊断为1型糖尿病。病情稳定后，患者透露她在患病前4天开始为生酮饮食以减轻体重。未发现其他诱发因素。这突出表明，生酮饮食可能会在先前未被识别的1型糖尿病出现时增加糖尿病酮症酸中毒的风险。
