WM. Aboznadah, MA. Tsoukas, XW. Hu and MR. Pasqua (2025). Euglycemic Ketoacidosis Postsleeve Gastrectomy in 2 People With Type 1 Diabetes Using Automated Insulin Delivery. JCEM case reports, 3(4), luaf021. https://doi.org/10.1210/jcemcr/luaf021

PubMed 40110569

[Abstract]
As the prevalence of obesity rises in those with type 1 diabetes, there are more people with this condition undergoing bariatric surgery. Unfortunately, there is an increased risk of diabetic ketoacidosis, especially with euglycemia, in the postoperative period of bariatric surgery in this population. Automated insulin delivery is becoming increasingly popular as a form of intensive insulin therapy with major benefits such as reducing hypoglycemia, but the risk of ketoacidosis remains. We describe 2 cases of mild euglycemic ketoacidosis in the postoperative period after sleeve gastrectomy in adults with type 1 diabetes on commercial automated insulin delivery. Ketoacidosis postbariatric surgery is an ongoing risk, despite advancements in diabetes therapies; the information provided from technologies, however, can better inform and prevent this risk.