Alcoholic Ketoacidosis

What is alcoholic ketoacidosis?

Glucose is the main source of fuel for body metabolic processes. Glucose and insulin are always working together. Glucose is a product of the food you eat. It is a kind of sugar. Insulin is from the pancreas. Alcohol inhibits the pancreas from producing insulin. Insulin is needed for glucose to be taken up into the cells of your body. When you start drinking alcohol, your cells are denied of their main ‘food’ – glucose. When the cells keep waiting and waiting for glucose to come ‘inside’, and they don’t ‘see’ it, they will begin to do something that is harmful to the body! They will start burning fat cells! The fat cells are not their primary source of energy but because they must survive, they have to go for what is available. Ketones are the products of fat breakdown. These ketones are acidic in nature. And the type of acidosis they will thus produce is called ketoacidosis. When alcohol is responsible for the ketoacidosis, it will be referred to as alcoholic ketoacidosis.

Other conditions can cause ketoacidosis:

  • shock
  • abnormal metabolism
  • large doses of aspirin
  • kidney disease

There are specific types of ketoacidosis:

  • alcoholic ketoacidosis due excessive alcohol use
  • diabetic ketoacidosis (DKA) due to type 1 diabetes
  • starvation ketoacidosis due to pregnancy-induced vomiting

Any of these conditions will increase how much keto acids will be in your blood. It will also influence the concentration of blood insulin as little insulin will be produced. When insulin levels are low, fat cells in your body will begin to undergo a breakdown. Ketones are hence products of fat breakdown.

What causes alcoholic ketoacidosis?

Alcoholic ketoacidosis will be developed if you are a ‘fan’ of alcohol. If you have so much of it in your body due to your long-term consumption of alcohol, you can develop the condition. Your body can get malnourished from too much alcohol in your body. You will find out that you find it very hard to feed well. Your loved ones will equally complain about this. Alcohol makes you starve yourself of food. When you don’t feed well, you won’t have enough insulin in your body. It is this malnourishment that will cause your body to develop alcoholic ketoacidosis.

Your overall health status, nutrition and drinking frequency will sum up in determining the severity of your alcoholic ketoacidosis.

What are the symptoms of alcoholic ketoacidosis?

If you have so much alcohol present in your blood, your symptoms might be pronounced. How much ketones are flowing in your blood will also affect your symptoms.

General symptoms of alcoholic ketoacidosis are:

  • slow movement
  • nausea
  • vomiting
  • agitation
  • confusion
  • decreased alertness or coma
  • abdominal pain
  • loss of appetite
  • Kussmaul’s sign – irregular, deep, and rapid breathing
  • fatigue
  • dehydration symptom e.g. dizziness, thirst, and lightheadedness

You should schedule an appointment with your doctor once you find out you have any of these symptoms.

Alcoholic ketoacidosis can occur together with the following conditions:

  • ethylene glycol poisoning
  • ulcers
  • liver disease
  • pancreatitis
  • kidney disease

These conditions must be ruled out first before further diagnostic tests are carried out on you.

How is alcoholic ketoacidosis diagnosed?

Before your doctor goes ahead to perform some diagnostic tests on you, much evaluation will be done from your medical history, alcohol habits and physical examination. The following tests will usually come up after these initial ones that have been just outlined.

Tests will include:

  • urine test – to check whether ketones are present
  • arterial blood gas test – measures how much oxygen you have in your blood and also assesses acid/base balance
  • blood urea nitrogen (BUN) and creatinine tests – determines the functionality of your kidneys
  • amylase and lipase tests –monitors how well your pancreas is working and also checks if any inflammation is present
  • anion gap calculation, which measures sodium and potassium levels
  • Blood chemistry panel (CHEM-20) – comprehensively looks at the rate of your metabolism
  • blood alcohol test
  • serum lactate test – evaluates how much lactate is in your blood

If your blood glucose level is high, another test might be needed to confirm whether you have diabetes. The test is called hemoglobin A1C (HgA1C) test.

How is alcoholic ketoacidosis treated?

The typical place to administer treatment for alcoholic ketoacidosis is in the emergency unit.  Right in the unit, your vital signs, that is, your breathing rate, heart rate, and blood pressure will be monitored. You will be receiving an intravenous fluid. Vitamins and nutrients that you might be given so as to help you feed well include:

  • potassium
  • magnesium
  • thiamine
  • phosphorus

If your condition is very severe, you might have to remain in the hospital for a very long period of time so you can receive intensive treatment. You won’t be discharged until your body is strong enough to start functioning normally without much medication.

What are the complications of alcoholic ketoacidosis?

One complication you will have is alcohol withdrawal. Medications will be given to you if it is severe. Another complication that can develop from alcoholic ketoacidosis is gastrointestinal bleeding.

Other complications that may be developed from this condition include:

  • psychosis
  • pancreatitis
  • coma
  • pneumonia
  • encephalopathy – a complete brain condition defined by muscle twitching, memory loss, and personality

What is the long-term outlook for alcoholic ketoacidosis?

If you are able to get diagnosed and treated before much damage has been done to your body tissues, your outlook is on the bright side.

You might experience a relapse into alcohol addiction but it can be prevented through helps from your doctor.

If you have developed scarred liver tissues (cirrhosis), you might see that your legs are swollen. You will also get exhausted easily and might occasionally get nauseated.

How alcoholic ketoacidosis can be prevented

So much of alcoholic-related complications and conditions can be minimized and completely avoided by not consuming alcohol heavily. Being a part of a local system where you can receive utmost support can help you regain your life and live without alcohol again. Eat well. Follow all the instructions you have been given by your doctor. And if anything comes up in the process of recovery, let your doctor know about it.

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