Starvation ketoacidosis associated with tirzepatide use for weight loss in a non-diabetic East Asian woman: a case report

This case demonstrates that tirzepatide can precipitate starvation ketoacidosis in non-diabetic individuals, particularly when gastrointestinal adverse effects or dietary restriction lead to caloric deprivation. As the first reported case in an East Asian patient, it highlights the need for emergency physicians to consider starvation ketoacidosis in patients using tirzepatide for weight loss who present with vomiting, poor intake, or rapid weight loss. Early recognition and appropriate metabolic assessment are essential, and in patients with preserved endogenous insulin secretion, prompt glucose administration may allow rapid recovery without need for insulin therapy.