Alcoholic ketoacidosis Emergency Medicine Journal


The absence of hyperglycemia makes diabetic ketoacidosis improbable. Patients with mild hyperglycemia may have underlying diabetes mellitus Diabetes Mellitus (DM) Diabetes mellitus is impaired insulin secretion and variable degrees alcoholic ketoacidosis smell of peripheral insulin resistance leading to hyperglycemia. Early symptoms are related to hyperglycemia and include polydipsia… Read more , which may be recognized by elevated levels of glycosylated hemoglobin (HbA1C).

  • You can reduce your alcohol consumption in a variety of ways, including completely eliminating it.
  • People who drink large quantities of alcohol may not eat regularly.
  • Hypertriglyceridemia is an important risk factor for cardiovascular diseases.
  • Fluids alone do not correct AKA as quickly as fluids and carbohydrates together.
  • Medications (such as Valium) may be given to reduce the risk of severe alcohol withdrawal symptoms.
  • If you are experiencing symptoms like a high ketone level and severe symptoms, such as nausea, you should seek medical attention as soon as possible.

Accordingly, physicians who treat diabetics known to consume large amounts of alcohol must be aware of the risk of alcoholic ketoacidosis in those patients. Heavy alcohol consumption (i.e., 200 grams of pure alcohol, or approximately 16 standard drinks, per day) can cause ketoacidosis in both diabetics and nondiabetics (Wrenn et al. 1991). 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. As a result, those patients frequently have very low blood sugar levels (although some people with alcoholic ketoacidosis have very high blood sugar levels, because the lack of insulin prevents glucose uptake from the blood into the tissues). Growth hormone, epinephrine, cortisol, and glucagon are all increased. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs.

The Dangers Of Drinking Alcohol

Third, alcohol may enhance the increase in triglyceride levels in the blood that usually occurs after a meal. The combination of alcohol-induced hypoglycemia, hypoglycemic unawareness, and delayed recovery from hypoglycemia can lead to deleterious health consequences. For example, Arky and colleagues (1968) studied five diabetics who experienced severe hypoglycemia after ingesting alcohol.

Risky Drinking Common in Cancer Survivors – Medscape

Risky Drinking Common in Cancer Survivors.

Posted: Wed, 23 Aug 2023 07:00:00 GMT [source]

Six cases of sudden cardiac arrest with alcoholic ketoacidosis have been reported. It was discovered that all three had excessive alcohol consumption and elevated levels of beta-hydroxybutyric acid. I did not find any evidence of myocardial infarction, tamponade, or right heart strain, all of which could have been caused by a pulmonary embolism. Alcoholic ketoacidosis develops when the body’s blood sugar level falls after eating a high-fat meal.

Alcoholic Ketoacidosis Vs Diabetic Ketoacidosis

Acute abdominal surgical emergencies, such as acute pancreatitis, should be considered differentials when abdominal pain is the main presentation. Lactic acid levels are often elevated because of hypoperfusion and the altered balance of reduction and oxidation reactions in the liver. Treatment may involve fluids (salt and sugar solution) given through a vein.

Lee TW, Chang SH, and Park DJ are members of Park DJ’s stable, along with Jang HN, Park HJ, Cho HS, Bae E, Lee TW, Chang SH, and Park DJ. In contrast to chronic alcohol consumption in the fed state—which raises blood sugar levels, resulting in hyperglycemia—alcohol consumption in the fasting state can induce a profound reduction in blood glucose levels (i.e., hypoglycemia). That effect has been observed in both type 1 and type 2 diabetics as well as in nondiabetics (Arky and Freinkel 1964). Hypoglycemia can have serious, even life-threatening, consequences, because adequate blood sugar levels are needed to ensure brain functioning.

Emergent Treatment of Alcoholic Ketoacidosis

It is essential to differentiate AKA from DKA to ensure that inappropriate insulin administration does not occur. The key tenants to management of AKA include fluid resuscitation and electrolyte correction. The main differential diagnoses for ketosis in our patient included AKA, starvation/fasting ketosis and DKA.

Leave a Comment

Your email address will not be published.