Alcoholic Ketoacidosis: What to Know About This Medical Emergency

Patients are usually tachycardic, dehydrated, tachypneic, present with abdominal pain, and are often agitated. There are many ways to prevent diabetic ketoacidosis and other diabetes complications. Sometimes, diabetic ketoacidosis can occur alcoholic ketoacidosis treatment at home with type 2 diabetes. In some cases, diabetic ketoacidosis may be the first sign of having diabetes. If you have diabetes or you’re at risk of diabetes, learn the warning signs of diabetic ketoacidosis and when to seek emergency care.

Glucose comes from the food you eat, and insulin is produced by the pancreas. 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. Fewer people seek out treatment for alcohol addiction than for any other mental illness.

History and Physical

He denies a history of diabetes mellitus, ingestion of any toxic alcohols, or recent illness. The patient should have blood glucose checked on the initial presentation. The next important step in the management of AKA is to give isotonic fluid resuscitation. Dextrose is required to break the cycle of ketogenesis and increase insulin secretion.

Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis. While ketosis refers to any elevation of blood ketones, ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention. The most common cause of ketoacidosis is diabetic ketoacidosis but can also be caused by alcohol, medications, toxins, and rarely, starvation. If you chronically abuse alcohol, you probably don’t get as much nutrition as your body needs. 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.

Check if you have diabetic ketoacidosis (DKA)

All chronic alcohol misusers attending the ED should receive intravenous B vitamins as recommended by The Royal College of Physicians.23 Strenuous efforts must be made to exclude concomitant pathology. How severe the alcohol use is, and the presence of liver disease or other problems, may also affect the outlook. Neurologically, patients are often agitated but may occasionally present lethargic on examination.

• Volume depletion is a strong stimulus to the sympathetic nervous system and is responsible for elevated cortisol and growth hormone levels.
• This allows the body to meet energy requirements in the absence of carbohydrates and protein; however, it results in a larger than usual amount of acids in your body.
• Elevated ketones are a sign of DKA, which is a medical emergency and needs to be treated right away.

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. https://ecosoberhouse.com/ 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. It also depends on how long it takes to get your body regulated and out of danger.

Age of Most People With Alcohol Disorders

AUD indicates more severe functional impairments that result from excessive drinking. The liver’s inability to synthesize and release glucose can also lead to dangerously high levels of lactate. Excess levels of lactate can result in lactic acidosis, which further complicates AKA.3,5 Excessive use of alcohol can also lead to other medical issues such as alcoholic cirrhosis. Heavy alcohol use can also impair the liver’s ability to synthesize and release glucose. These two factors decrease the body’s normal levels of readily available energy, and it responds by breaking down fat and producing ketones.

Alcoholic ketoacidosis doesn’t occur more often in any particular race or sex. In addition, AKA is often precipitated by another medical illness such as infection or pancreatitis. Triglycerides stored in adipose tissue undergo lipolysis and are released into the circulation as free fatty acids bound ionically to albumin. Free fatty acids are removed by the liver, where they primarily undergo oxidation to hydroxybutyric acid and acetoacetate and subsequently are reesterified to triglyceride. Decreased insulin and elevated glucagon, cortisol, catecholamine, and growth hormone levels can increase the rate of ketogenesis. During starvation, there is a decrease in insulin secretion and an increase in the production of counter-regulatory hormones such as glucagon, catecholamines, cortisol, and growth hormone.