A woman is admitted for possible appendicitis. We fast her and given her IV fluids so she doesn't get dehydrated. After the first bag of saline (salt water), we switch to dextrose (sugar water) per our IV fluids protocol.
Patient refuses the dextrose.
"But why?" my nurse asks, bewildered. It's just sugar water.
"Oh, I'm gluten-free," the patient answers. "I'm on a diet."
We stare. That literally has no bearing on the situation. We give IV fluids to people who get anaphylaxis from gluten with no issues, never mind someone who just chooses to not eat gluten.
"It's sugar water," the nurse says.
"I'm on a zero-sugar ketogenic diet. I don't want the dextrose."
I literally have no words for someone who doesn't understand basic biology. Zero sugar diet is incompatible with life.