CASE COMMUNICATIONS
IMAJ | volume 28
Journal 1, January 2026
pages: 56-57
A Case of Lactation Ketoacidosis Followed by Striking Hyperglycemia
1 Department of Internal Medicine, Shaare Zedek Medical Center, affiliated with Hadassah–Hebrew University School of Medicine, Jerusalem, Israel
2 Department of Emergency Medicine, Shaare Zedek Medical Center, affiliated with Hadassah–Hebrew University School of Medicine, Jerusalem, Israel
Summary
Lactation ketoacidosis (LA) is a well-documented phenomenon in cows, known as bovine ketoacidosis. It occurs when there is a negative energy balance because of a high glucose demand for milk production. LA in humans is rare, although the first case was reported in 1982 [1] and several cases have been reported in recent years. In most cases, there is a recognizable precipitating factor, often fasting or consuming a low calorie or low carbohydrate diet. However, a case of recurrent LA with no apparent trigger has also been reported [1]. In most cases the patients were euglycemic on presentation; however, hypoglycemia had been reported [2]. In this study, we present a case of LA and hypoglycemia on presentation with an unexpected striking hyperglycemia after treatment with dextrose.