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January 2026
Lior Tolkin MD, Osama Muhtaseb MD, Bezalel Pearl MD

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.

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