title: Ketoacidosis in a non-diabetic woman who was fasting during lactation.
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.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. sarah.hudak@med.uni-tuebingen.de.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Hudak
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. dietrich.overkamp@med.uni-tuebingen.de.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Overkamp
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. robert.wagner@med.uni-tuebingen.de.|German Center for Diabetes Research (DZD e.V.), Otfried-Müller-Str. 10, 72076, Tübingen, Germany. robert.wagner@med.uni-tuebingen.de.
authors.forename: Robert
authors.initials: R
authors.lastname: Wagner
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. hans-ulrich.haering@med.uni-tuebingen.de.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. hans-ulrich.haering@med.uni-tuebingen.de.|German Center for Diabetes Research (DZD e.V.), Otfried-Müller-Str. 10, 72076, Tübingen, Germany. hans-ulrich.haering@med.uni-tuebingen.de.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Häring
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. martin.heni@med.uni-tuebingen.de.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. martin.heni@med.uni-tuebingen.de.|German Center for Diabetes Research (DZD e.V.), Otfried-Müller-Str. 10, 72076, Tübingen, Germany. martin.heni@med.uni-tuebingen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Heni
mesh_terms: D000328:Adult; D005215:Fasting / Q000502:physiology*; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D006985:Hyperventilation / Q000209:etiology; D007657:Ketone Bodies / Q000652:urine; D007662:Ketosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D007774:Lactation / Q000502:physiology*; D010710:Phosphates / Q000627:therapeutic use; D011188:Potassium / Q000627:therapeutic use; D011644:Puerperal Disorders / Q000188:drug therapy / Q000503:physiopathology* / Q000652:urine; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D012965:Sodium Chloride / Q000627:therapeutic use; D013610:Tachycardia / Q000209:etiology; D059246:Tachypnea / Q000209:etiology
chemical_list: D007657:Ketone Bodies; D010710:Phosphates; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D005947:Glucose; D011188:Potassium