Mr. Khuong, weighing 134 kg with a body mass index (BMI) of 45.3, was diagnosed with severe obesity. Tests at Tam Anh General Hospital Hanoi revealed a decreased pH level, significantly elevated urine ketones, and concentrated blood. Doctor Phung Quang Tung, from the Intensive Care Department, diagnosed Mr. Khuong with diabetic ketoacidosis and a metabolic disorder. His pancreatic enzyme levels were also elevated, with lipase at 1,415 U/L, more than 20 times the normal range, indicating a risk of acute pancreatitis.

According to Doctor Tung, influenza is a common respiratory infection that is mostly benign. However, Mr. Khuong's uncontrolled obesity and diabetes complicated his condition. Excess fat accumulation leads to metabolic disorders, increasing insulin resistance and dyslipidemia. When a flu infection occurs, the body's insulin demand rises, forcing it to break down fat for energy. This process results in ketoacidosis and a sudden increase in blood lipids. The accumulation of these ketone bodies acidifies the blood, causing systemic dysfunction that can become life-threatening if not treated promptly.

High concentrations of free fatty acids and triglycerides disrupt microcirculation and damage pancreatic cells, leading to acute pancreatitis. "Severe ketoacidosis combined with acute pancreatitis accelerates and intensifies multi-organ failure", Doctor Tung explained.

Doctors advise Mr. Khuong on weight loss and managing obesity and diabetes. *Photo: Tam Anh General Hospital*

Mr. Khuong received emergency fluid and electrolyte replacement to combat dehydration. Doctors also controlled his blood sugar with intravenous insulin to inhibit ketone production and prevent acid-base imbalance. Due to the damaged pancreas, Mr. Khuong was kept nil per os (NPO) and received nutrition intravenously, reducing the burden on his digestive system.

By the 7th day of treatment, Mr. Khuong's blood sugar levels stabilized, acidosis was under control, and he could resume eating. His abdominal pain subsided, and he was discharged. Currently, Mr. Khuong continues insulin injections to manage his diabetes and is following an obesity treatment protocol to prevent future complications.

In Vietnam, the prevalence of overweight and obesity is increasing. Various factors contribute to obesity, including an unhealthy diet, chronic stress, insomnia, genetic predispositions, endocrine issues, and environmental influences. Doctor Tung highlighted that losing 10% of body weight can significantly reduce the risk of numerous systemic diseases such as cardiovascular disease, diabetes, and sleep apnea.

Khue Lam

*Patient's name has been changed