Alcoholic Ketoacidosis develops primarily as a result of excessive alcohol consumption and inadequate food intake. When individuals indulge in heavy drinking, it leads to a cascade of physiological changes in the body, creating a perfect storm for alcoholic ketosis. In addition, AKA is often precipitated by another medical illness such as infection or pancreatitis. Alcoholic ketoacidosis is a condition that can happen when you’ve had a lot of alcohol and haven’t had much to eat or have been vomiting. When this happens, it can cause ketones, which are acids, to build up in your blood.
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If not treated quickly, alcoholic ketoacidosis may be life-threatening. The clinical and biochemical features of AKA are summarised in boxes 1 and 2. The classical presentation is of an alcoholic patient with abdominal pain and intractable vomiting following a significant period of increased alcohol intake and starvation. There may be a what is alcoholic ketoacidosis history of previous episodes requiring brief admissions with labels of “query pancreatitis” or “alcoholic gastritis”. Alcoholic ketoacidosis (AKA) is an acute metabolic acidosis seen in persons with a recent history of binge drinking and little or no nutritional intake. Without enough insulin, the body begins to break down fat as fuel.
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- If you are diagnosed with alcoholic ketoacidosis, you’ll typically require hospitalization for close monitoring and specialized care.
- This test will provide information about your sugar levels to help determine whether you have diabetes.
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Similar symptoms in a person with alcohol use disorder may result from acute pancreatitis, methanol (wood alcohol) or ethylene glycol (antifreeze) poisoning or diabetic ketoacidosis. The doctor must exclude these other causes before diagnosing alcoholic ketoacidosis. Several mechanisms are responsible for dehydration, including protracted vomiting, decreased fluid intake, and inhibition of antidiuretic hormone secretion by ethanol. Volume depletion is a strong stimulus to the sympathetic nervous system and is responsible for elevated cortisol and growth hormone levels.
Clinical studies of alcoholic ketoacidosis
- If the diagnosis of alcohol withdrawal syndrome is established, consider the judicious use of benzodiazepines, which should be titrated to clinical response.
- Cirrhosis of the liver can cause exhaustion, leg swelling, and nausea.
- This activity illustrates the evaluation and treatment of alcoholic ketoacidosis and explains the role of the interprofessional team in managing patients with this condition.
- Your doctor and other medical professionals will watch you for symptoms of withdrawal.
During this period of starvation, vomiting continues and abdominal pain develops, leading the patient to seek medical attention. One complication of alcoholic ketoacidosis is alcohol withdrawal. Your doctor and other medical professionals will watch you for symptoms of withdrawal. Your doctor may also admit you to the intensive care unit (ICU) if you require ongoing care. The length of your hospital stay depends on the severity of the alcoholic ketoacidosis.
- If the patient’s blood glucose level is significantly elevated, AKA may be indistinguishable from diabetic ketoacidosis (DKA).
- When this happens, it can cause ketones, which are acids, to build up in your blood.
- But don’t let fear keep you from taking good care of yourself.
- This can occur as soon as one day after a drinking binge, depending on nutritional status, overall health status, and the amount of alcohol consumed.
Strongly consider providing thiamine supplementation to patients with alcohol dependence even without signs of thiamine deficiency. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. This drop in blood sugar causes your body to decrease the amount of insulin it produces. Your cells need insulin to use the glucose in your blood for energy.
Appropriately evaluate the patient for any life-threatening complications before a transfer is considered. American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.
They provide some energy to your cells, but too much may cause your blood to become too acidic. Intravenous benzodiazepines can be administered based on the risk of seizures from impending alcohol withdrawal. Antiemetics such as ondansetron or metoclopramide may also be given to control nausea and vomiting.
Clinical ReviewsAlcoholic Ketoacidosis: Etiologies, Evaluation, and Management
Pyruvate and lactate are then maintained in steady state at much higher levels than normal. This results in a decrease in circulating lactic acid and an increase in acetoacetate. Patients improved rapidly (within 12 hours) with intravenous glucose and large amounts of intravenous saline, usually without insulin (although small amounts of bicarbonate were sometimes used). Carbohydrate and fluid replacement reverse this process by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones and by providing metabolic substrate. Dextrose stimulates the oxidation of the reduced form of nicotinamide adenine dinucleotide (NADH) and aids in normalizing the ratio of NADH to nicotinamide adenine dinucleotide (NAD+).
