Alcoholic ketoacidosis: MedlinePlus Medical Encyclopedia

The patient might be tachycardic, tachypneic, profoundly orthostatic, or frankly hypotensive as a result of dehydration from decreased oral intake, diaphoresis, and vomiting. Detection of acidosis may be complicated by concurrent metabolic alkalosis due to vomiting, resulting in a relatively normal pH; the main clue is the elevated anion gap. If history does not rule out toxic alcohol ingestion as a cause of the elevated anion gap, serum methanol and ethylene glycol levels should be measured. ConclusionSigns and symptoms of AKA can often be non-specific and should be considered in patients with recent cessation of heavy alcohol use with vomiting and metabolic derangements. It can be treated promptly with fluids, dextrose, and thiamine. An elevated INR in a patient with chronic alcoholism may be due to vitamin K deficiency, which has not been previously reported.

• Prevention of AKA involves the treatment of chronic alcohol abuse.
• Failure to make the diagnosis can result in severe metabolic abnormalities, acidosis, and shock.
• The resulting increase in the NADH/NAD+ ratio inhibits hepatic gluconeogenesis and elevates the ratio of hydroxybutyric acid to acetoacetic acid.
• When your liver uses up its stored glucose and you aren’t eating anything to provide more, your blood sugar levels will drop.

What are the complications of alcoholic ketoacidosis?

Lactic acid levels are often elevated because of hypoperfusion and the altered balance of reduction and oxidation reactions in the liver. Group meetings provide support for people trying to quit drinking. Meetings are widely available at little-to-no cost in most communities. Support groups can be a valuable source of support and can be combined with medication and therapy. Limiting the amount of alcohol you drink will help prevent this condition.

How can I prevent alcoholic ketoacidosis?

Hormone-sensitive lipase is normally inhibited by insulin, and, when insulin levels fall, lipolysis is up-regulated, causing release of free fatty acids from peripheral adipose tissue. 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, alcoholic ketoacidosis smell it can cause ketones, which are acids, to build up in your blood. If not treated quickly, alcoholic ketoacidosis may be life-threatening. Arrange follow-up to evaluate patients after the resolution of symptoms, in order to detect other complications of chronic alcohol abuse. The patient may benefit from an alcohol rehabilitation program.

Treatment of Severe Acidosis

Alcoholic ketoacidosis is a problem caused by drinking a lot of alcohol without eating food. 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.

• 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.
• However, if an AKA patient is lethargic or comatose, an alternative cause should be sought.
• These conditions have to be ruled out before a medical professional can diagnose you with alcoholic ketoacidosis.
• Free fatty acids are removed by the liver, where they primarily undergo oxidation to hydroxybutyric acid and acetoacetate and subsequently are reesterified to triglyceride.
• Consider referral to a counselor at an alcohol treatment center.

This buildup of ketones can produce a life-threatening condition known as ketoacidosis. For patient education information, see the Mental Health and Behavior Center, as well as Alcoholism and Alcohol Intoxication. In contrast to diabetic ketoacidosis, the predominant ketone body in AKA is β-OH. Routine clinical assays for ketonemia test for AcAc and acetone but not for β-OH. Clinicians underestimate the degree of ketonemia if they rely solely on the results of laboratory testing.

Signs and symptoms of alcoholic ketoacidosis

Patients & Visitors

Alcoholic Ketoacidosis: Mind the Gap, Give Patients What They Need

• Diagnosis is by history and findings of ketoacidosis without hyperglycemia.
• Medicines may be given to prevent alcohol withdrawal symptoms.
• They provide some energy to your cells, but too much may cause your blood to become too acidic.
• If you have symptoms of alcoholic ketoacidosis, your doctor will perform a physical examination.
• Treatment may involve fluids (salt and sugar solution) given through a vein.
• Cirrhosis of the liver can cause exhaustion, leg swelling, and nausea.