INS and diabetic ketoacidosis: Apart from the obviously high prevalence of this complication, another interesting fact is that, in the setting of the reduced carbohydrate intake that follows surgery along with the continued insulin regimen, diabetic ketoacidosis may not necessarily present with hyperglycemia, as in the recently reported case of a 43 years-old woman who developed euglycemic diabetic ketoacidosis 10 days after she underwent sleeve gastrectomy (40).