Euglycemic Ketoacidosis in a Non-diabetic Patient After Tirzepatide Use: A Cautionary Tale

A 48-year-old woman lost 16 pounds after self-titrating tirzepatide to 5 mg weekly over six weeks.

• The patient experienced persistent diarrhea, appetite loss, nausea, and abdominal pain prior to hospital admission.
• Laboratory findings included a pH of 7.2, bicarbonate level of 17 mmol/L, and elevated ketones, with normal serum glucose.
• A diagnosis of tirzepatide-induced euglycemic ketoacidosis (EKA) was made.
• The patient was managed with fluid resuscitation and recovered without complications.
• EKA may be a rare but serious adverse effect associated with tirzepatide, especially during appetite suppression and caloric restriction.

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