Metabolic Acidosis
Metabolic acidosis is a life-threatening disease that can arise due to ketoacidosis induced by diabetes mellitus, malnutrition, consumption of alcohol or lactate acidosis, kidney dysfunction or opioid ingestion (that is, methanol, ethylene glycol or salicylate). To identify the cause of acidosis, anamnesis, health symptoms, and samples of blood are used.
In lactating cattle, ketosis during lactation is a well-known condition and is well defined in veterinary literature . During lactation, owing to milk production and secretion, the metabolic demand is greater in the lactating female than in the non-lactating female. The disease is unusual because increased food consumption usually compensates for it. In prior case studies, ketoacidosis not linked to lactation has been stated to be caused by a low-carbohydrate diet.
Gluconeogenesis satisfies the brain’s need for energy when the body’s glycogen storage is exhausted, as in malnutrition, and, later, due to low insulin levels, mobilisation of free fatty acids into ketone bodies[5]; the limited amount of glucose provided by gluconeogenesis is used by the offspring for galactopoiesis.
In the USA during the 1960s, low carbohydrate diets were popular and peaked around 2000, prompted by books published by Dr Stillman and Dr Atkins. A Swedish general practitioner initiated the low-carbohydrate high-fat (LCHF) diet in Sweden in 2005, and awareness was created when the founder launched a blog opposing the conventional dietary advertising for diabetes patients. The diet has been extremely popular since then.
Can Keto Diet cause ketoacidosis?
In our situation, in spite of lack of diagnosis, a stable lactating woman had ketoacidosis. In rare cases, a diet with a low carbohydrate content could induce a ketoacidosis. However, as far as we know, this is the first case recorded in the non-diabetic patient’s literature of ketoacidosis, combined with low glucose, a high fat diet, lacquer. Physiologic stressors like breastfeeding, diseases, breastfeeding twins and, in recent times, even bariatric procedure have been considered a drive factor towards ketoacidosis in previous instances, in lactating anti-diabetic women and in other non diabetic patients. In the lactation process the stressor appeared to be the LCHF diet and its high supply of milk.
New diets are common and the knowledge spreads rapidly and is easily accessible through our modern communication through internet and blogs. Internet writers may be individuals who advocate diet or financially motivated marketers. It is a tremendous undertaking to upgrade and provide our group with appropriate preparation.
Patients ought to be made aware that the active loss of weight while breastfeeding does not arise due to the heavy demand for milk-producing substrates and because there is little information as to how people use ketones.
Conclusions
A pregnant woman has a strong demand for milk substrates. A LCHF diet decreases the sub-strate volume and contributes to a detrimental energy balance. Thus, this form of diet during lactation should be avoided.
Our case indicates that medical providers should be conscious that the rigid LCHF diet also induces ketosis and in extreme cases even ketoacidosis, which needs to be detected and treated promptly to mitigate morbidity.
