Jenkins et al2 suggested that alcohol induced mitochondrial damage might account for AKA. Alcohol produces structural changes in human liver mitochondria within days. Fulop and Hoberman5 argued that a functional abnormality is more likely to be responsible, as even severe AKA usually improves rapidly with treatment. They attributed this to the administration of therapy (intravenous dextrose) rather than the withdrawal of the toxin, ethanol. 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.
A clinical diagnosis of alcoholic ketoacidosis should be made. Patients require fluid resuscitation, careful electrolyte monitoring, and treatment to avoid alcohol withdrawal. Arterial Blood Gas – Most likely the blood gas analysis will show a low or normal pH. With a lower hydroxy bicarbonate level, metabolic acidosis will be present.
Who Is at Risk for Alcoholic Ketoacidosis?
Note information about the patient’s social situation and the presence of intoxicating agents besides alcohol. Assess the patient’s airway and manage as clinically indicated. But don’t let fear keep you from taking good care of yourself. Ask your diabetes treatment team for help when you need it. Although the underlying pathophysiology is complex, a proper comprehension greatly aids in the diagnosis and management of this condition. American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information.
- If your body is not producing insulin, ketone bodies will begin to build up in your bloodstream.
- The metabolism of alcohol itself is a probable contributor to the ketotic state.
- An elevated INR in a patient with chronic alcoholism may be due to vitamin K deficiency, which has not been previously reported.
An altered level of consciousness should prompt consideration of alternative diagnoses such as hypoglycaemia, seizures, sepsis, thiamine deficiency, or head injury. Arterial blood gas and biochemistry studies reveal a raised anion gap metabolic acidosis without evidence of lactic or diabetic ketoacidosis. The patient should have blood glucose checked on the initial presentation. The next important step in the management of AKA is to give isotonic fluid resuscitation.
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If the diagnosis of alcohol withdrawal syndrome is established, consider the judicious use of benzodiazepines, which should be titrated to clinical response. Refer the patient alcoholic ketoacidosis smell for treatment of chronic alcohol abuse. For patient education information, see the Mental Health and Behavior Center, as well as Alcoholism and Alcohol Intoxication.
Similar symptoms in a person with alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning). Consuming large amounts rapidly or regularly can cause health problems, including organ damage, coma,… Read more may result from acute pancreatitis Acute Pancreatitis Acute pancreatitis is sudden inflammation of the pancreas that may be mild or life threatening but usually subsides. Gallstones and alcohol abuse are the main causes of acute pancreatitis. Read more , methanol (wood alcohol) or ethylene glycol (antifreeze) poisoning or diabetic ketoacidosis Diabetic Ketoacidosis Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus.