If severe hypokalemia is present dextrose containing fluids can be held until potassium levels are normalized. Other electrolyte abnormalities concomitantly present with alcohol alcoholic ketoacidosis smell 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.

People who consume a lot of alcohol during one occasion often vomit repeatedly and stop eating. If the vomiting and starvation go on for a day or more, the liver’s normal stores of sugar (glucose) decrease. The low glucose stores combined with lack of food intake cause low blood glucose levels. Without insulin, most cells cannot get energy from the glucose that is in the blood.

Signs and symptoms

Growth hormone, epinephrine, cortisol, and glucagon are all increased. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs. Carbohydrate and fluid replacement reverse this process by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones and by providing metabolic substrate. Dextrose stimulates the oxidation of the reduced form of nicotinamide adenine dinucleotide (NADH) and aids in normalizing the ratio of NADH to nicotinamide adenine dinucleotide (NAD+).

• When you don’t eat, various processes take place in your body.
• He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
• Early symptoms are related to hyperglycemia and include polydipsia…
• Similar symptoms in a person with alcohol use disorder Alcohol Use Alcohol (ethanol) is a depressant (it slows down brain and nervous system functioning).

Many people end up in urgent care or the emergency room because of the early symptoms of alcoholic ketoacidosis, which include abdominal pain. Ketones are a type of acid typically flushed out of the body, but if you drink a lot of alcohol, it can lead to a buildup of ketones. If your ketone levels get too high, you might start suffering from alcoholic ketoacidosis, also known as alcoholic ketosis. The main differential diagnoses for ketosis in our patient included AKA, starvation/fasting ketosis and DKA.

Medically-Supervised Detox

It should be noted that ketoacidosis is very rare9 and not a significant risk factor for AKA unless someone is also chronically abusing alcohol. Alcoholic ketoacidosis is a serious condition, and the potential outcome could be deadly, especially if you don’t get proper medical care as soon as possible. Following resuscitation, our patient had plasma electrolyte levels corrected, nutritional supplementation provided and completed an alcohol detoxification regimen. Given the early recognition of AKA and concurrent management, our patient had a good outcome.