17 December 2024
: Case report 
Exploring Hypoglycemic Ketoacidosis in Nondiabetic Patients on Tirzepatide: Is Starvation the Culprit?
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease, Adverse events of drug therapy, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology
Zouheir Bitar
ACDE 1,2*, Heba M. Abdelraouf BDF 2, Rania A. Maig ABDE 2, Ossama Maadarani EG 1, Zainab Zouheir Bitar BC 3, Hussien Dashti AD 2
DOI: 10.12659/AJCR.946133
Am J Case Rep 2024; 25:e946133
Figure 1. Mechanism of hypoglycemic ketoacidosis. Depleting available glycogen stores in the liver and tirzepatide can increase insulin release and inhibit the effect of counterregulatory hormones, thereby decreasing hepatic gluconeogenesis in a state of insulin resistance in the peripheral tissue. This figure was created using digital art on an iPad, an Apple pencil, and an application called “Notebook”.