What Is Alcoholic Ketoacidosis? The Impact of a Buildup of Ketones in Your Blood
Without insulin, most cells cannot get energy from the glucose that is in the blood. Cells still need energy to survive, so they switch to a back-up mechanism to obtain energy. Fat cells begin breaking down, producing compounds called ketones. Ketones provide some energy to cells but also make the blood too acidic (ketoacidosis).
History and Physical
It is a clinical diagnosis with patients presenting with tachycardia, tachypnea, dehydration, agitation, and abdominal pain. This activity illustrates the evaluation and treatment of alcoholic ketoacidosis and explains the role of the interprofessional team in managing patients with this condition. Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity.
Get Help for Alcohol Use Disorder to Improve Your Overall Health
Excessive alcohol consumption often causes malnourishment (not enough nutrients for the body to function well). 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.
Alcoholic ketoacidosis: a cause of sudden death of chronic alcoholics
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. If you have symptoms of alcoholic ketoacidosis, your doctor will perform a physical examination. They will also ask about your health history and alcohol consumption. If your doctor suspects that you’ve developed this condition, they may order additional tests to rule out other possible conditions. After these test results are in, they can confirm the diagnosis.
Symptoms of Alcoholic Ketoacidosis
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. When your liver uses up its stored glucose and you aren’t eating anything to provide more, your blood sugar levels will drop. A person who isn’t eating properly and getting the nutrition the body needs from food because they’re drinking heavy amounts of alcohol instead, starts to get a buildup of excessive amounts of ketones in the body.
How Can Alcoholic Ketoacidosis Be Prevented?
- 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.
- If severe hypokalemia is present dextrose containing fluids can be held until potassium levels are normalized.
- 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.
Restoration of volume status and correction of the acidosis may be difficult to accomplish in the emergency department (ED). Evaluate the patient for signs of alcohol withdrawal syndrome, which may include tremors, agitation, diaphoresis, tachycardia, hypertension, seizures, or delirium. Exclude other causes of autonomic hyperactivity and altered mental status. If the diagnosis of alcohol withdrawal syndrome is established, consider the judicious use of benzodiazepines, which should be titrated to clinical response. The toxicokinetics that are pertinent to the diagnosis of AKA include the rate of alcohol oxidation in the body.
Emergency Department Care
After finishing his medical degree at the alcoholic ketoacidosis smell University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education. Treatment for Alcoholic Ketoacidosis (AKA) primarily focuses on correcting the dehydration, electrolyte imbalances, and acidosis that characterize this condition. People with this condition are usually admitted to the hospital, often to the intensive care unit (ICU). The condition is an acute form of metabolic acidosis, a condition in which there is too much acid in body fluids. Alcoholic ketoacidosis is the buildup of ketones in the blood due to alcohol use.
Assess for clinical signs of thiamine deficiency (Wernicke-Korsakoff syndrome). Specifically look for nystagmus, confusion, ataxia, confabulation, and restriction of extraocular movements. Strongly consider providing thiamine supplementation to patients with alcohol dependence even without signs of thiamine deficiency. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. Intravenous benzodiazepines can be administered based on the risk of seizures from impending alcohol withdrawal. Antiemetics such as ondansetron or metoclopramide may also be given to control nausea and vomiting.
Clinical studies of alcoholic ketoacidosis
Depending on how bad their alcohol abuse has been or if medically-assisted alcohol detox will be needed for withdrawal symptoms, entering into a treatment center may be a necessary option. Professional medical staff can assist in the difficult process of withdrawal, making the transition into sobriety less daunting. Correct diagnosis is essential for effective treatment of AKA, and these laboratory tests provide the necessary data to confirm the presence of the condition. Several factors contribute to the onset of AKA, including starvation-induced hypoinsulinemia—a deficiency of insulin in the blood—as well as the direct oxidation of alcohol to its ketone metabolites. These agents are rarely used for the management of severe metabolic acidosis.