Page title background

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a metabolic condition resulting from excessive alcohol consumption. 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 is, how it occurs and how it’s treated. Understanding alcoholic ketoacidosis can help you recognize and prevent it.

What Is Alcoholic Ketoacidosis?

Alcoholic ketoacidosis (AKA) is a complex metabolic condition. It’s helpful to know a little bit about how the body works to understand this condition. The body’s cells require both glucose and insulin to operate. Your body gets the glucose it needs from the food you eat, in the form of sugar, and your pancreas produces insulin. The cells use the insulin from your pancreas to process glucose and create energy.

Excessive drinking damages the pancreas, impacting insulin production. When this happens, your cells will have to burn fat to produce energy. This process creates blood acids called ketones. Having too many ketones in the bloodstream is known as a dangerous condition called ketoacidosis. Ketoacidosis can also occur in those with type one diabetes. As you might already know, those with type one diabetes are unable to produce enough insulin. Without insulin injections, they’re likely to end up in a state of ketoacidosis.

Malnutrition associated with excessive drinking can increase the risk of developing ketoacidosis. Someone who drinks a lot for an extended period may not eat enough or they may vomit. Those actions can have a starvation effect, limiting the body’s insulin production. The combination of pancreas impairment and starvation can lead to ketoacidosis.

Symptoms of Alcoholic Ketoacidosis

The condition’s symptoms vary based on a number of factors, including how much the individual has had to drink, how well-nourished their body is and their overall current health. It also depends on how many ketones have entered the bloodstream. Some of ketoacidosis’s common symptoms are:

  • Abdominal pain
  • Confusion or agitation
  • Lack of alertness
  • Coma
  • Fatigue
  • Slow movement
  • Irregular breathing
  • Loss of appetite
  • Nausea or vomiting
  • Dizziness
  • Lightheadedness
  • Intense thirst

Many of these symptoms can be dangerous, even fatal, so it’s important to seek medical attention right away if you suspect ketoacidosis. Sudden death due to alcoholic ketoacidosis is common among those who binge drink on an empty stomach or lose nutrients through vomiting.

Another common sign of ketoacidosis is a distinct breath smell. The alcoholic ketoacidosis smell is like acetone or nail polish remover, noticeable when someone exhales ketone molecules. The diabetic form of ketoacidosis may have a sweet and fruity smell rather than one like acetone.

How Is Alcoholic Ketoacidosis Diagnosed?

Diagnosing alcoholic ketoacidosis is a complicated task, in part because other, similar conditions are common among those with alcohol use disorders, such as pancreatitis, liver or kidney disease, ulcers and alcohol poisoning. In some cases, the symptoms of one of these other conditions can mimic those of AKA. Doctors may need to rule out these other conditions before making a diagnosis. To figure out what is happening inside the body and make sure no other conditions are present, a doctor might order any of the following tests:

  • A blood alcohol test: Note that high blood alcohol content is not always necessary for alcoholic ketoacidosis to take place.
  • A blood chemistry panel: A blood chemistry panel evaluates how well the metabolism is functioning.
  • A blood glucose test: This test will determine how much glucose is in the blood, which can help show pancreatic function.
  • A blood urea nitrogen test: This test will determine how well the kidneys are functioning.
  • An amylase or lipase test: These tests will monitor the pancreas and check for pancreatitis, which is inflammation of the pancreas. This condition can also cause abdominal pain, fever, nausea and irregular pulse, all symptoms of ketoacidosis.
  • An arterial blood gas test: This test will measure the blood’s oxygen levels and pH balance.
  • An anion gap calculation: An anion gap calculation measures sodium and potassium levels. In the case of malnutrition, these levels may be too low. A doctor might need to inject potassium before stimulating insulin production.
  • Serum lactate test: A serum lactate test will show the blood’s lactate levels. Another form of acidosis, lactic acidosis, can be the result of restricted oxygen.
  • Urine test: A urine test will allow the doctor to measure the number of ketones produced. Remember, excess ketones are what cause ketoacidosis.

With these tests, the doctor could find evidence of diabetes, which will require specialized treatment. If a patient has a concurrent illness or condition along with ketoacidosis, the next steps may need to be different.

Most patients end up in the emergency room, where doctors are able to monitor their vital signs and inject necessary fluids into their veins.

How to Treat Alcoholic Ketoacidosis

Treatments for alcoholic ketoacidosis vary. Most patients end up in the emergency room, where doctors are able to monitor their vital signs and inject necessary fluids into their veins. It’s crucial to get to an emergency care facility as fast as possible if you suspect alcoholic ketoacidosis. To counter malnutrition, a doctor might inject vitamins and nutrients such as:

  • Magnesium
  • Phosphorus
  • Potassium
  • Thiamine

Ongoing treatment in an intensive care unit might be necessary, depending on the condition’s severity. Additional conditions and complications may require extra care. Patients often need hydration, potassium repletion and dextrose injections to stimulate insulin production. Every patient is different, and careful monitoring is essential during the treatment process.

How Does Alcohol Withdrawal Affect Treatment?

If the patient experiencing alcoholic ketoacidosis has an alcohol use disorder, withdrawal symptoms can complicate recovery. Doctors will need to monitor the patient for dangerous alcohol withdrawal symptoms. They might need to administer different medicines if the patient is dealing with withdrawal on top of ketoacidosis. Some other complications might include:

Contact Gateway Foundation for Recovery Services

Contact Gateway Foundation for Recovery Services

Excessive drinking can lead to frightening conditions like ketoacidosis. The risk of developing this condition is one of the reasons an alcohol use disorder is dangerous. Though alcoholic ketoacidosis can be reversible, it’s best to prevent it by limiting alcohol intake and never consuming alcohol on an empty stomach. For those with alcohol use disorders, professional treatment is necessary to stop excessive drinking.

If you or someone you know has an alcohol use disorder, they may be at risk of developing alcoholic ketoacidosis. Seeking treatment sooner than later might prevent this life-threatening condition.

The professional team at Gateway Foundation is here to help. For over 50 years, we’ve been administering evidence-based treatments with a compassionate approach to help patients find lasting freedom from addiction. We’ll be with you for life, with various inpatient and outpatient services, including an alumni support network. To learn how you can start a journey toward recovery, contact us at Gateway Foundation today.

Addiction Destroys Dreams, We Can Help