A Case of Euglycemic Diabetic Ketoacidosis With Tirzepatide Use and Severe Calorie Restriction

Jan 30, 2026JCEM case reports

A case of diabetic ketoacidosis without high blood sugar linked to tirzepatide use and very low calorie intake

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Abstract

(EDKA) occurred in a 30-year-old man with no known diabetes using .

  • Tirzepatide, a type of medication that helps with weight loss, was taken alongside intermittent fasting and a low-carbohydrate diet.
  • The combination of glucagon-like peptide-1 receptor agonists and ketosis-inducing diets may pose serious health risks.
  • Unsupervised use of such medications can lead to dangerous conditions like EDKA.
  • Medical supervision is emphasized as essential for safe weight management practices, especially with medication and dietary changes.

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Key numbers

24.4 mEq/L to 14.5 mEq/L
Bicarbonate Level Decrease
Initial and 12-hour post-admission bicarbonate levels
7.5 mmol/L
β-Hydroxybutyrate Level
β-Hydroxybutyrate level on admission
15 pounds (∼7 kg)
Weight Loss
Weight loss attributed to and dietary changes

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