Alcoholic Ketoacidosis: Etiologies, Evaluation, and Management

alcoholic ketoacidosis pathophysiology

Vomiting and/or diarrhoea is common and can lead to hypovolaemia and potassium depletion. Signs of shock including tachycardia and hypotension can be complicated by overlap of alcohol withdrawal 2. Electrolyte abnormalities are common to this condition and can precipitate fatal cardiac arrhythmias 3, 4. The prognosis for alcoholic ketoacidosis is good as long as it’s treated early. However, the long-term prognosis depends on the severity of the underlying alcohol abuse disorder. Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity.

What are the symptoms of alcoholic ketoacidosis?

  • Although AKA can cause a modest elevation in serum glucose, significant hyperglycaemia in patients with metabolic acidosis, the presence of ketones and a suggestive history would make DKA the more likely diagnosis.
  • But it can happen after an episode of binge drinking in people who do not chronically abuse alcohol.
  • If the vomiting and starvation go on for a day or more, the liver’s normal stores of sugar (glucose) decrease.
  • If you have any additional complications during treatment, this will also affect the length of your hospital stay.
  • You can prevent alcoholic ketoacidosis by limiting your alcohol intake.
  • If you can’t eat for a day or more, your liver will use up its stored-up glucose, which is a type of sugar.

You can learn how to reduce your alcohol intake or eliminate it altogether. Joining a local chapter of Alcoholics Anonymous may provide you with the support you need to cope. You should also follow all of your doctor’s recommendations to ensure proper nutrition and recovery.

Treatment of Alcoholic Ketoacidosis

  • If you develop any of these symptoms, seek emergency medical attention.
  • If your body is not producing insulin, ketone bodies will begin to build up in your bloodstream.
  • The main differential diagnoses for ketosis in our patient included AKA, starvation/fasting ketosis and DKA.
  • Subsequent mismanagement can lead to increasing morbidity and mortality for patients.
  • Signs of shock including tachycardia and hypotension can be complicated by overlap of alcohol withdrawal 2.

One complication of alcoholic ketoacidosis is alcohol withdrawal. Your doctor and other medical professionals will watch you for symptoms of withdrawal. These conditions have to be ruled out before a medical professional can diagnose you with alcoholic ketoacidosis. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time.

Alcoholic Ketoacidosis: Etiologies, Evaluation, and Management

  • Without insulin, your cells won’t be able to use the glucose you consume for energy.
  • She was discharged home and has been well on follow-up appointments.
  • Group meetings provide support for people trying to quit drinking.
  • Alcoholic ketoacidosis is a problem caused by drinking a lot of alcohol without eating food.
  • Glucose comes from the food you eat, and insulin is produced by the pancreas.

If you are diagnosed with alcoholic ketoacidosis, your recovery will depend on a number of factors. Seeking help as soon as symptoms arise reduces your chances of serious complications. Treatment for alcohol addiction is also necessary to prevent a relapse of alcoholic ketoacidosis. People who drink large quantities of alcohol may not eat regularly.

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. You can prevent alcoholic ketoacidosis by limiting your alcohol intake.

alcoholic ketoacidosis pathophysiology

The length of your hospital stay depends on the severity of the alcoholic ketoacidosis. It also depends on how long it takes to get your body regulated and out of danger. If you have any additional complications during treatment, this will also affect the length of your hospital stay. If your blood glucose level is elevated, your doctor may also perform a hemoglobin A1C (HgA1C) test. This test will provide information about your sugar levels to help determine whether you have diabetes. Glucose comes from the food you eat, and insulin is produced by the pancreas.

  • The key tenants to management of AKA include fluid resuscitation and electrolyte correction.
  • This is why diagnosis and subsequent treatment can sometimes be challenging, but it’s crucial to receive a proper and timely diagnosis to obtain the correct treatment.
  • The prognosis for alcoholic ketoacidosis is good as long as it’s treated early.
  • It also depends on how long it takes to get your body regulated and out of danger.

Your prognosis will be impacted by the severity of your alcohol use and whether or not you have liver disease. Prolonged used of alcohol can result in cirrhosis, or permanent scarring of the liver. Cirrhosis of the liver can cause exhaustion, leg swelling, and nausea. American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information.

alcoholic ketoacidosis pathophysiology

alcoholic ketoacidosis pathophysiology

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. The presence of a high anion gap, although not specific, is suggestive of AKA in a patient with an appropriate clinical history 9. Additional measurements that may help determine the diagnosis of AKA include beta-hydroxybutyrate levels (high in AKA, low in DKA) and serum alcohol concentration (typically low or undetectable) 8.

Alcoholic Ketoacidosis Symptoms

alcoholic ketoacidosis pathophysiology

When you drink alcohol, your pancreas may stop producing insulin for a short time. Without insulin, your cells won’t be able to use the glucose you consume for energy. However, following senior medical review, given a recent history of drinking alcohol to excess, the diagnosis of AKA was felt more likely. Whilst a decreased conscious level may have been expected, our patient was lucid enough to report drinking one to two bottles of wine per day for the past 30 years, with a recent binge the day prior to admission.

Conditions

Not eating enough or vomiting alcoholic ketoacidosis pathophysiology can lead to periods of starvation. Take our free, 5-minute alcohol abuse self-assessment below if you think you or someone you love might be struggling with alcohol abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of an alcohol use disorder. The test is free, confidential, and no personal information is needed to receive the result. They provide some energy to your cells, but too much may cause your blood to become too acidic.

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