Van, 1,70 m tall and weighing 90 kg, had a BMI of 31,1, classifying him with class 2 obesity. He embarked on a self-proclaimed "body cleanse" by consuming only fruit. After 10 days, he lost 13 kg but developed severe fatigue, loss of taste, a dry cough, and constant thirst. He became critically weak and was admitted to Tam Anh General Hospital Hanoi for examination.

Blood test results revealed his blood sugar level was 51,7 mmol/l, nearly 10 times the normal range. His triglyceride level was 16,9 mmol/l (the normal index is below 1,7), accompanied by high blood pressure, electrolyte imbalance, and liver damage.

Doctor Le Ba Ngoc, Head of the General Internal Medicine Department, explained that the patient's extremely high blood sugar caused his blood to thicken like syrup, increasing plasma osmotic pressure. This condition can lead to hyperosmolar coma, a dangerous acute complication of diabetes. Furthermore, his triglyceride levels surged, making his blood milky and posing a risk of acute pancreatitis.

Van was briefed before intravenous insulin injection. *Photo: Tam Anh General Hospital*

According to Doctor Ngoc, Van had long-standing undiagnosed diabetes. His prolonged fruit-only diet inadvertently caused his blood sugar to spike, leading to progressive metabolic disorders and various associated complications. The patient's 13 kg weight loss in 10 days was actually a sign of severe endocrine disorder, resulting from dehydration and electrolyte imbalance.

Van received treatment with intravenous insulin, aiming for a gradual reduction in blood sugar, as a sudden drop could cause cerebral edema. The recommended reduction rate was 3-4 mmol/l per hour, with continuous adjustments. Concurrently, the patient received fluid replacement, electrolyte adjustments, lipid disorder control, osmotic pressure monitoring, liver function support, and blood pressure management.

After 24 hours, his dehydration improved, hemodynamics stabilized, and blood sugar returned to a safe level, prompting a switch to subcutaneous insulin.

After 8 days of treatment, the patient's appetite improved, his condition stabilized, and he was discharged. He is currently continuing outpatient treatment, adhering to his diet, managing his weight, and taking prescribed medication.

Doctor Ngoc emphasized that the patient needs a long-term weight loss plan and diabetes treatment to manage his metabolic disorder.

The doctor advised overweight and obese individuals to undergo regular diabetes screenings and avoid extreme diets, such as fruit-only regimens, for weight loss. If symptoms like frequent urination, excessive thirst, fatigue, or rapid weight loss appear, patients should seek medical examination for timely diagnosis and treatment.

Thanh Ba