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Learning from errors
A severe case of iatrogenic lactation ketoacidosis
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  • Published on:
    Re:lactation ketoacidosis-bmj case report

    Ketoacidosis is a direct result of exteremly low cellular magnesium levels. Gluconeogenesis is impaired at Glucose6 Phosphatase G6-Pase. G6- Pase is very magnesium dependent so if magnesium levels are severely reduced blood glucose levels plummet starving neurons of energy. The neurons in the hypothalamus signal the gut get more in 'the hunger pangs in Obesity'. Pyruvate carboxylase is also very magnesium dependent and if...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re:lactation ketoacidosis-bmj case report

    Thank you for your interest in our paper and for your comments. As was correctly pointed out in the letter, patients who are kept NPO should be given IV glucose supplementation. This was not done for our patient and this is indeed one of the reasons we decided to present her case in the Learning from errors section of the journal. We would like to clarify that it is in fact very unlikely for a non- breastfeeding patient t...

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    Conflict of Interest:
    None declared.
  • Published on:
    lactation ketoacidosis-bmj case report

    It was indeed a very interesting report to read and was actually fascinated with the title initially. After reading the case report I am tempted to make some comments on the title which may be quite misleading .Even a normal person( meaning who is not breast feeding) will become ketotic if made nil by mouth for whatever reason for 3 days .But here the breast feeding probably aggravated the process further so it is dif...

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    Conflict of Interest:
    None declared.