Alcoholic Ketoacidosis: Signs, Symptoms, and Treatment

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. Laboratory analysis plays a major role in the evaluation of a patient with suspected alcoholic ketoacidosis. If you develop any of these symptoms, seek emergency medical attention. Administration of insulin alone in AKA leads to rapid fall in blood sugar and confirms the diagnosis of AKA, while DKA requires a substantial amount of insulin without dextrose initially. One should be given insulin alone to look for the initial response under strict supervision.

• In alcoholic or starvation conditions, low insulin levels are secondary to absolute or relative hypoglycemia.
• Alcohol can induce several types of lipid alterations, including elevated triglyceride levels in the blood (i.e., hypertriglyceridemia), reduced levels of low-density lipoprotein (LDL) cholesterol, and elevated levels of high-density lipoprotein (HDL) cholesterol.
• With early diagnosis and appropriate treatment, patients improve rapidly and serious complications are prevented.
• Second, diabetics who have consumed alcohol, particularly those with type 1 diabetes, experience a delayed glucose recovery from hypoglycemia.
• People who consume those high amounts of alcohol typically have been drinking and not eating for days and/or have vomited or developed other illnesses from drinking.

Going on a drinking binge when your body is in a malnourished state may cause abdominal pain, nausea, or vomiting. Infection or other illnesses such as pancreatitis can also trigger alcoholic ketoacidosis in people with alcohol use disorder. If you have consumed too much alcohol and have not eaten anything or vomited, you may have an alcoholic ketoacidosis. Alcoholic ketoacidosis is a life-threatening condition that can be fatal if left untreated. A person’s chances of developing this reaction increase as they consume more alcohol in a short period of time.

Medical Professionals

If you feel ill or stressed or you’ve had a recent illness or injury, check your blood sugar level often. You might also try a urine ketone test kit you can get at a drugstore. All alcoholic patients presenting with acute illness should be offered contact with addiction services prior to or following discharge wherever possible.

In the event that you are diagnosed with ketoacidosis, you should follow your doctor’s instructions on how to manage the condition and avoid future flare-ups. Alcohol use that causes malnutrition is responsible for the development of alcoholic ketoacidosis. The symptoms of this condition are often unpleasant, such as nausea, vomiting, and abdominal pain. People who have chronic liver disease or who have coexisting liver diseases suddenly cease to drink alcohol.

Ketoacidosis

Because malnourished people are more likely to consume a lot of alcohol, they tend to consume a lot of it as well. Drinking too much alcohol can result in diabetes and, more importantly, a lack of diabetes control. It is possible to become diabetic ketoacidosis after drinking alcohol at times, but this is extremely alcoholic ketoacidosis smell rare. People who have type 1 diabetes are more likely to develop this disease. A woman in her third trimester of pregnancy can also experience severe ketoacidosis, as can someone who is hyperventilating. Diabetes and alcohol consumption are the two most common underlying causes of peripheral neuropathy.

• Hepatic generation of ketone bodies is usually stimulated by the combination of low insulin levels and high counter-regulatory hormone levels, including glucagon.
• Alcohol metabolism in the liver, however, actually shuts down the process of gluconeogenesis and thus the second line of defense against hypoglycemia.
• You may get vitamin supplements to treat malnutrition caused by excessive alcohol use.
• Hypokalemia and increased anion-gap are usually seen with similar mechanisms to those seen in DKA.
• Going on a drinking binge when your body is in a malnourished state may cause abdominal pain, nausea, or vomiting.
• The first function, which involves most of the pancreatic cells, is the production of digestive enzymes.

An increased anion gap metabolic acidosis occurs when these ketone bodies are present as they are unmeasured anions. Alcoholic ketoacidosis[5] occurs in patients with chronic alcohol abuse and liver disease and usually develops following abrupt withdrawal of alcohol or an episode of acute intoxication. It is not uncommon for the ingested ethanol to have already been metabolized, leading to low or normal serum levels when checked. In normal alcohol metabolism, the ingested ethanol is oxidized to acetaldehyde and then to acetic acid with the enzyme alcohol dehydrogenase, during which process the coenzyme nicotinamide adenine dinucleotide (NAD+) is reduced to NADH.

Treatment

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. Oral intake abruptly decreases in the majority of cases as a result of a precipitating event such as pancreatitis, gastritis, or aspiration pneumonia.

DSMS is an individualized plan that provides opportunities for educational and motivational support for diabetes self-management. The condition is an acute form of metabolic acidosis, a condition in which there is too much acid in body fluids. The remainder of the patient’s laboratory evaluation – including liver enzymes, amylase, and lipase – were within normal limits, and methanol, ethylene glycol, salicylate, and digoxin levels were negative. Of note in the table above, the patient’s INR was greater than 11, above the upper limit of the assay, and this was confirmed by repeating the test. Efficient and timely management can lead to enhanced patient outcomes in patients with AKA. However, after adequate treatment, it is equally essential to refer the patient to alcohol abuse rehabilitation programs to prevent recurrence and long-term irreversible damage from alcohol abuse.

Treatment / Management

Nausea, vomiting, and abdominal pain are all symptoms of alcoholic ketoacidosis. The pathology of alcoholic ketoacidosis (AKA) is a condition that results from the overconsumption of alcohol. This can lead to a build-up of ketones in the body, which can then lead to ketoacidosis. Ketoacidosis is a serious condition that can lead to coma and death if not treated promptly. Symptoms of AKA include nausea, vomiting, abdominal pain, and confusion. If you suspect that you or someone you know has AKA, it is important to seek medical help immediately.

Third, alcohol may enhance the increase in triglyceride levels in the blood that usually occurs after a meal. Untreated, diabetic ketoacidosis can lead to loss of consciousness and, eventually, death. Empowering the patient regarding management is hence of the utmost importance. Diabetes self-management education (DSME) and diabetes self-management support (DSMS) are recommended at the time of diagnosis of prediabetes or diabetes and throughout the lifetime of the patient.