What Is Alcoholic Ketoacidosis? The Impact of a Buildup of Ketones in Your Blood

If you need help talking to a loved one, look into family resources for alcohol addiction treatment. Ketone production can be further stimulated in malnourished, vomiting patients or in those who are hypophosphatemic.6 Both conditions are seen commonly in alcoholic patients with alcoholic ketoacidosis. A 1991 case series found that the most common symptoms among 74 patients presenting with AKA are nausea (76%), vomiting (73%), and abdominal pain (62%).

Without the alcoholic ketoacidosis treatment of insulin, ketones build up in the bloodstream, causing the life-threatening condition of AKA. It enters the bloodstream and affects every part of the body, making the drinker vulnerable to serious health consequences. Chronic alcohol abuse exposes the central nervous, digestive, circulatory, immune, skeletal, and muscle systems to severe and long-lasting damage. Alcoholic ketoacidosis is a disease that develops from drinking too much alcohol. Learn about this harmful condition and what you can do to prevent it. Diabetic ketoacidosis is a common and generally well-understood medical condition in urgent and acute care centers.

Tox & Hound – aka AKA

The patient presented with acute shortness of breath, generalised abdominal pain, and vomiting. Blood gas analysis indicated severe high anion gap metabolic acidosis with elevated serum ketones and modest hyperglycaemia which was initially treated as diabetic ketoacidosis . A diagnosis of AKA was later made after obtaining a thorough history of his binge drinking. The patient subsequently responded well to thiamine and aggressive fluid resuscitation. This case highlights the importance of a well-documented patient history and in-depth knowledge of ketoacidosis. Symptoms often include abdominal pain, vomiting, agitation, a fast respiratory rate, and a specific “fruity” smell.

An elevated anion gap metabolic acidosis and ketosis is the classic present. However, a mixed acid-base disorder may be present especially if vomiting is contributing to a hypochloremic alkalosis.

Clinical Scenario

Glucose also increases oxidation of NADH to NAD, thereby further stopping ketone production. Once fluid and electrolyte losses are replaced, change fluids to 5% dextrose in half normal saline until oral intake is assured.1 Patients with alcoholic ketoacidosis are not hyperosmolar. Unlike treatment of diabetic ketoacidosis, cerebral edema is of little concern with large volumes of fluid administration. Even with vigorous fluid resuscitation, in our review of the literature, cerebral edema has not been reported among those being treated for alcoholic ketoacidosis. Alcoholic ketoacidosis is also closely linked to malnutrition, which is a common problem among people who engage in chronic alcohol abuse. When someone who is malnourished goes on an episode of binge drinking, abdominal pain, nausea, and vomiting can occur. Infection and other diseases such as pancreatitis can also cause alcoholic ketoacidosis in people with alcoholism.

It is proposed that alcoholic ketoacidosis is a significant cause of death among people with chronic alcoholism although the true prevalence is unknown. Estimation of prevalence and outcomes of this population is limited by difficulty in diagnosing the condition and the presence of multiple disorders at presentation. The patients need fluid resuscitation, close monitoring of electrolytes, and treatment to prevent alcohol withdrawal. They also need to have a complete history and physical for a complete differential diagnosis. Patients develop acidosis, which causes an increase in respiratory rate and fluid loss. If you or a loved one experiences any of these symptoms, especially after binge drinking, seek professional help immediately. Visit a hospital for emergency medical care and consider a treatment facility to treat alcoholism.

Clinical ReviewsAlcoholic Ketoacidosis: Etiologies, Evaluation, and Management

If they can’t use glucose because there’s not enough insulin, your body switches to another method to get energy — breaking down fat cells. Treatment includes administration of intravenous saline to rehydrate and 5% dextrose to turn off gluconeogenesis.

When your fat cells break down, they release ketones, which are a type of acid that provides your cells with some energy. The problem is that high levels of ketones can cause the blood to become too acidic, which can be life-threatening if it’s left untreated. AKA is a common syndrome of patients with alcohol use disorder in the ED. Diagnosis of AKA requires the detection of ketone bodies in the urine and serum.