Severe Lactic Acidosis and High Blood Sugar After Surgery Improving with Thiamine in a Patient Using Semaglutide and Following a Restrictive Diet

A young, nondiabetic woman on a restrictive diet developed severe lactic acidosis and hyperglycemia after surgery.

• Thiamine deficiency can lead to type B lactic acidosis, a serious condition that may occur in certain dietary contexts.
• Lactic acidosis and hyperglycemia worsened despite stable hemodynamics and hydration in the patient.
• Empiric intravenous thiamine resulted in rapid normalization of lactate and glucose levels.
• Preoperative nutritional risk assessment may be important for patients on restrictive diets undergoing surgery.
• Early administration of thiamine could be beneficial in similar perioperative situations.

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