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. Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic…

alcoholic ketoacidosis

On hospital day three, the patient was discharged home with outpatient services for his alcohol use disorder. A 49-year-old male with a history of alcohol abuse presents to the ED with complaints of generalized abdominal pain and vomiting for the last 36 hours. The patient is well-known to the department for alcohol-related visits and continues to drink daily. On arrival, he is tachycardic and tachypneic, and physical examination findings include dry mucous membranes, decreased sakin turgor, epigastric tenderness, and a tremor in both hands. 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.


If the patient’s blood glucose level is significantly elevated, AKA may be indistinguishable from diabetic ketoacidosis (DKA). Doctors base the diagnosis on the characteristic symptoms and their relation to alcohol abuse combined with laboratory test results that show increased amounts of ketones and acid in the bloodstream but normal or low blood glucose levels. Under normal conditions, cells rely on free blood glucose as the primary energy source, which is regulated with insulin, glucagon, and somatostatin. Patients can have a long-standing history of alcohol use and may also present following binges.

alcoholic ketoacidosis

Alcoholic ketoacidosis happens when excessive amounts of alcohol cause digestive problems. Failure to follow a holistic approach, such as eating a balanced diet, combined with excessive drinking and/or vomiting, leads to blood that is too acidic. Alcoholic ketoacidosis can be fatal, and requires treatment right away. If a person is already malnourished due to alcoholism, they may develop alcoholic ketoacidosis. This can occur as soon as one day after a drinking binge, depending on nutritional status, overall health status, and the amount of alcohol consumed.

Vitamin supplementation

Acetic acid (an acyl group carrier) is linked with coenzyme A (a thiol) to produce Acetyl-CoA. Lactic acid levels are often elevated because of hypoperfusion and the altered balance of reduction and oxidation reactions in the liver. alcoholic ketoacidosis smell DiscussionThis case highlights the importance of diagnosing patients with AKA and providing the appropriate treatment. With early diagnosis and appropriate treatment, patients improve rapidly and serious complications are prevented.

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. Calcium oxalate crystals in the urine also suggests ethylene glycol poisoning. If you know anything about type 1 diabetes, then you can probably understand why a problem can occur here. To “enter ketosis” generally requires limiting carbohydrate intake to a maximum of around 50 grams per day.


If the diagnosis of alcohol withdrawal syndrome is established, consider the judicious use of benzodiazepines, which should be titrated to clinical response. If you or a loved one experiences any of these symptoms, especially after binge drinking, seek professional help immediately. Visit a hospital for emergency medical care and consider a treatment facility to treat alcoholism. If you need help talking to a loved one, look into family resources for alcohol addiction treatment. Your doctor may also admit you to the intensive care unit (ICU) if you require ongoing care.