Ketoacidosis due to Starvation

Ketoacidosis is a metabolic state wherein ketone bodies increase with decreasing serum bicarbonate level and pH. Ketosis may occur during starvation because of poor carbohydrate intake, which leads to lipolysis and ketogenesis (1). Here the brain and other tissues use ketone bodies as an alternative energy source instead of glucose. Although ketoacidosis may be frequently seen as diabetic ketoacidosis in association with type I diabetes mellitus, poor dietry intake, prolonged fasting, malnutrition, gastric banding disorders, alcoholism, therapeutic ketogenic diets (used for the treatment of epileptic seizures, Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerozis), Atkins diet, and last decade’s famous Dukan diet may induce ketoacidosis without diabetes mellitus (2-8). This is known as starvation ketoacidosis. Here, we present the case of a 38-year-old female with anorexia nervosa who was diagnosed with starvation ketoacidosis.