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CC BY-NC-ND 4.0 · J Lab Physicians 2021; 13(03): 280-282
DOI: 10.1055/s-0041-1731139
Case Report

Recurrent Diabetic Ketoacidosis following Bariatric Surgery: The Role of Micronutrients

Philip Moseley
1   Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, United Kingdom
,
Mohamed H Ahmed
1   Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, United Kingdom
2   Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, United Kingdom
,
Henry Owles
1   Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, United Kingdom
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Abstract

We report a case of a 29-year-old woman admitted twice to our hospital with diabetic ketoacidosis (DKA) within 45 days following her bariatric surgery. The first admission required intensive care during her postoperative days after bariatric surgery. Subsequently, she continued to report high level of ketones on a daily basis. At her second admission, she presented with all three criteria of DKA. She was treated with a standard protocol for DKA, but ketones plasma level remained high despite significant improvement in pH and glycemic control. The administration of thiamine replacement was associated with normalization of the hyperketonemia. Thiamine deficiency can be associated with bariatric surgery and can lead to high ketone level in individuals with type 1 diabetes.

Keywords

thiamine - bariatric surgery - diabetes


Publication History

Article published online:
28 June 2021

© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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