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Starvation Acidosis

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Starvation Ketoacidosis In Pregnancy

Introduction: Starvation ketosis outside pregnancy is a rare phenomenon and is unlikely to cause a severe acidosis. Pregnancy is an insulin resistant state due to placental production of hormones including glucagon and human placental lactogen. Insulin resistance increases with advancing gestation and this confers a susceptibility to ketosis, particularly in the third trimester. Starvation ketoacidosis in pregnancy has been reported and is usually precipitated by a period of severe vomiting. Ketoacidosis has been associated with intrauterine death. Case report: A 22-year-old woman in her third pregnancy presented at 32 weeks gestation with a 24 h history of severe vomiting. She had been treated for an asthma exacerbation with prednisolone and erythromycin the day prior to presentation. She was unwell, hypertensive (145/70 mmHg) with a sinus tachycardia and Kussmaul breathing. Urinalysis showed ++++ ketones, + protein and pH 5. Fingerprick glucose was 4 mmol/l and ketones were 4.0 mmol/l. Arterial blood gas showed pH 7.27, PaCO2 1.1 kPa, base excess −23, bicarbonate 8.6 mmol/l and lactate 0.6 mmol/l. The anion gap was 20. Serum ethanol, salicylates and paracetamol levels were unde Continue reading >>

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Popular Questions

  1. ta7832549

    I've been dealing with daily bad insomnia for a while now - waking up with a racing heartbeat in the middle of the night, unable to go back to sleep. Never had these problems before keto, unwilling to give up the latter. I had my thyroid and hormone levels checked out, and the length and frequency of recurrence ruled out stress as a cause.
    Turns out, once I stopped drinking coffee and tea entirely, the insomnia went away and I've now slept through three full nights of blissful sleep. Posting under a throw-away because I feel a bit stupid for not ruling out such an obvious cause earlier, in the hope that it'll help the occasional other ketoer.

  2. WillowWagner

    No reason to feel stupid. If you could drink tea and coffee for years with no problem, why would you suspect they had suddenly "turned" on you? You know how people say their tolerance for alcohol is vastly diminished? I wonder if the same is true for lots of people with caffeine. (I have no science for this, and I offer no explanation, I have just noticed and I wonder.)
    Good for you for figuring it out!

  3. SparkleToGetFit

    Just posted an eerily similar comment to yours before scrolling down to read the rest of the comments. Lol, whoops. Glad I'm not the only one who's curious. I'll share if I find anything!

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