Alcoholic Ketoacidosis: What to Know About This Medical Emergency

The dextrose will also increase glycogen stores and diminish counterregulatory hormone levels. It is essential to administer thiamine before any glucose administration to avoid Wernicke’s encephalopathy preci[itation. If severe hypokalemia is present dextrose containing fluids can be held until potassium levels are normalized. Other electrolyte abnormalities concomitantly present with alcohol abuse and poor oral intake include hypomagnesemia and hypophosphatemia. Magnesium and phosphate levels should be measured and repleted if the serum levels are found low.

Can alcoholic ketoacidosis cause sudden death?

Alcoholic ketoacidosis (AKA) is a specific group of symptoms and metabolic state related to alcohol use. Symptoms often include abdominal pain, vomiting, agitation, a fast respiratory rate, and a specific "fruity" smell. Consciousness is generally normal. Complications may include sudden death.

The primary difference is that AKA isn’t synonymous with hyperglycemia (high blood glucose). Someone suffering from AKA may have normal, low (hypoglycemia), or elevated glucose levels. Ethanol metabolism results in NAD depletion manifesting as a higher ratio of the reduced form of nicotinamide adenine dinucleotide (NADH) to NAD. When glycogen stores are depleted in a patient stressed by concurrent illness or volume depletion, insulin secretion is also suppressed. Under these same conditions, glucagon, catecholamine, and growth hormone secretion are all stimulated. This hormonal milieu inhibits aerobic metabolism in favor of anaerobic metabolism and stimulates lipolysis.


He was given IV valium for alcohol withdrawal, and thiamine, folate, and phosphate were repleted. He was hospitalized for three days for management of AKA and alcohol withdrawal, then discharged once tolerating oral intake and in good condition. He was seen three weeks later in the emergency department for a similar presentation.

alcoholic ketoacidosis treatment at home

This can occur due to dehydration from drinking, low glucose levels from not eating and throwing up after binge drinking and a buildup of ketones in the body from frequent drinking. It’s important to note that alcoholic ketoacidosis (AKA) is a different condition than diabetic ketoacidosis (DKA). You do not have to be diabetic to suffer from alcoholic ketoacidosis.

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After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. 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. This leads to depleted levels of both carbohydrates and protein.

alcoholic ketoacidosis treatment at home

Binge drinking affects the body in complicated ways and can prohibit organs from performing their necessary functions. Alcoholic ketoacidosis can be painful, dangerous and even fatal, often requiring a visit to an emergency room or intensive care unit for recovery. It’s vital to understand what this condition alcoholic ketoacidosis symptoms is, how it occurs and how it’s treated. Understanding alcoholic ketoacidosis can help you recognize and prevent it. The reversal of ketosis and vigorous rehydration are central in the management of AKA. In addition to isotonic fluid replacement, dextrose-containing intravenous fluids are needed.

Individualized, evidence based treatment, to fit your needs.

Although the underlying pathophysiology is complex, a proper comprehension greatly aids in the diagnosis and management of this condition. Fluids alone do not correct AKA as quickly as fluids and carbohydrates together. Thiamine supplementation should also be given upon initiation of dextrose. Note information about the patient’s social situation and the presence of intoxicating agents besides alcohol. Enter search terms to find related medical topics, multimedia and more.

alcoholic ketoacidosis treatment at home

Laboratory studies show a serum bicarbonate of 10 mEq/L, an anion gap of 30, a serum glucose of 95 mg/dL, a lactic acidosis with pH 7.2, hypophosphatemia, and trace ketonuria. He denies a history of diabetes mellitus, ingestion of any toxic alcohols, or recent illness. Current management focuses on the administration of saline and glucose to reverse volume and glycogen depletion, and the high NADH/NAD ratio. Thiamine 100 mg parenterally is an obligatory initial measure in the treatment of malnourished chronic alcoholics.

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