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Indian Journal of Emergency Medicine 11(4):p 289-292, Oct - Dec. 2025. | DOI: 10.21088/ijem.2395.311X.11425.14
Case Report
Diet Induced Ketoacidosis in Euglycemic Patient
Apurva Sahay, Arun Kaushik, Kishalay Datta
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Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Emergency Medicine 11(4):p 289-292, Oct - Dec. 2025. | DOI: 10.21088/ijem.2395.311X.11425.14
How Cite This Article:
Sahay A, Kaushik A, Datta K. Diet Induced Ketoacidosis in Euglycemic Patient. Ind J Emerg Med. 2025;11(4):289–92.Timeline
Received : October 14, 2025
Accepted : November 14, 2025
Published : December 30, 2025
Abstract
Anion gap metabolic acidosis is a frequently encountered clinical issue in emergency medicine, often signalling a wide range of underlying pathologies. The diagnostic process requires careful consideration of various potential causes, which may span toxic ingestions, renal insufficiencies, endocrine disturbances, infectious diseases, and cardiac-related conditions. In high-income or developed healthcare settings, one relatively uncommon but clinically significant aetiology of metabolic acidosis is ketosis. While more prevalent in scenarios involving uncontrolled diabetes or prolonged fasting, ketosis is less often seen as a primary presentation in emergency departments in these regions. Its atypical nature in such contexts can delay diagnosis and appropriate management. Recognizing ketosis as a potential contributor to anion gap acidosis remains essential, particularly when more common causes have been excluded. Prompt identification and targeted treatment based on the underlying cause of the ketosis are crucial to improving patient outcomes. In this case report, we discuss an interesting case of diet induced ketoacidosis, the immediate emergency diagnosis and prompt treatment in the emergency department and final outcome.
References
- 1. Paoli A. Ketogenic diet for obesity: friend or foe? Int J Environ Res Public Health. 2014; 11(2): 2092–107.
- 2. Zhou C., Byard R.W. Septic ketoacidosis—a potentially lethal entity with renal tubular epithelial vacuolization. J Forensic Sci. 2017; 62: 122–4.
- 3. Charfen M.A., Fernández-Frackelton M. Diabetic ketoacidosis. Emerg Med Clin North Am. 2005; 23: 609–28.
- 4. Gomez-Arbelaez D., Crujeiras A.B., Castro A.I., et al. Acid base safety during the course of a very low-calorie-ketogenic diet. Endocr J. 2017; 58: 81–90.
- 5. Chen T., Smith W., Rosenstock J.L., et al. A lifethreatening complication of Atkins diet. Lancet. 2006; 367:958.
- 6. Ullah W., Hamid M., Mohammad Ammar A.H., et al. Another “D” in Mudpiles? A review of diet-associated nondiabetic ketoacidosis. J Investig Med High Impact Case Rep. 2018; 6: 2324709618796260.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Sahay A, Kaushik A, Datta K. Diet Induced Ketoacidosis in Euglycemic Patient. Ind J Emerg Med. 2025;11(4):289–92.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| October 14, 2025 | November 14, 2025 | December 30, 2025 |
DOI: 10.21088/ijem.2395.311X.11425.14
Keywords
KetoacidosisKetogenic dietEuglycemic ketoacidosisDietingSearch for Similar Articles
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Timeline
| Received | October 14, 2025 |
| Accepted | November 14, 2025 |
| Published | December 30, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
