Obesity Surgery

, Volume 29, Issue 1, pp 347–349 | Cite as

Normal Blood Glucose and High Blood Ketones in a Critically Unwell Patient with T1DM Post-Bariatric Surgery: a Case of Euglycemic Diabetic Ketoacidosis

  • Jemma DowsettEmail author
  • Rebecca Humphreys
  • Robert Krones
Brief Communication


Obesity is a global epidemic. Obesity in those with type I diabetes (T1DM) contributes to poor glycemic control and complications. Bariatric surgery as management for obesity is increasing in those with T1DM. However, there is limited data pertaining to these patients and their potential post-operative complications. These complications include severe hyperglycemia and diabetic ketoacidosis (DKA). This case study describes a 43-year-old woman with T1DM whose post-operative period following her bariatric surgery was complicated by euglycemic DKA. Post-bariatric surgery the incidence of those with T1DM experiencing DKA can be up to 1 in 4. Clinicians should be vigilant of this atypical presentation of DKA to avoid misdiagnosis potentially resulting in delays in treatment. Close monitoring in the post-operative period is warranted.


Bariatric surgery Obesity Type 1 diabetes Euglycemic diabetic ketoacidosis Post-operative complications 


Compliance with Ethical Standards

Ethics Statement

Informed consent was obtained from the individual participant included in this study.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Bachelor of Emergency Health (Paramedic), Bachelor of Biomedical ScienceNortheast Health WangarattaWangarattaAustralia
  2. 2.Bachelor of Nursing (RN), Credentialed Diabetes EducatorNorth East DiabetesWangarattaAustralia
  3. 3.Fellow of the Royal Australasian College of Physicians (FRACP), Senior Lecturer at the Rural Clinical SchoolUniversity of Melbourne, Northeast Health WangarattaWangarattaAustralia

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