A Case of Hypoglycemia Associated With the Ketogenic Diet and Alcohol Use

Journal of the Endocrine Society
Christopher Spoke, Samar Malaeb

Abstract

The ketogenic diet, which has become an increasingly popular diet, severely restricts carbohydrate intake to shunt metabolism towards fatty acid oxidation and production of ketones as a fuel source. There have been many studies illustrating the positive effects of a ketogenic diet in weight loss and other benefits; however, the long-term effects and potential adverse events of a ketogenic diet have not been well studied or documented in literature. There are a few case reports of ketogenic diet resulting in hypoglycemia. We report a case of hypoglycemia with a blood glucose of 39 mg/dL and ketosis in a 69-year-old woman who strictly followed a ketogenic diet for nearly one year. She presented with malaise, sugar cravings, and mental fogginess, and after intake of alcoholic beverages, was admitted to the hospital with hypoglycemia. She had elevated beta-hydroxybutyrate, and low insulin and C-peptide, all consistent with a starvation ketosis. This case illustrates that adherence to a ketogenic diet for a prolonged period of time, in combination with alcohol intake, can disrupt normal glucose homeostatic mechanisms and result in a significant degree of hypoglycemia. This pattern of hypoglycemia may not present with classic symptom...Continue Reading

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Citations

May 29, 2021·Frontiers in Cardiovascular Medicine·Sara D'ImperioCarlo Pappone

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