Alcoholic Ketoacidosis: Signs, Symptoms, and Treatment

Alcoholic Ketoacidosis: Signs, Symptoms, and Treatment

BRENZAVVY may increase the risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue. A lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when used in combination with BRENZAVVY. It is the first affordably priced, once-daily alcoholic ketoacidosis SGLT2 inhibitor, indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Looking for addiction treatment in Columbus, Ohio or the surrounding areas?

alcoholic ketoacidosis treatment

Other vitamins and minerals, such as magnesium, are added to the saline solution. Coute is an assistant professor of emergency medicine at the University of Alabama-Birmingham Heersink School of Medicine. It is important for individuals recovering from AKA and their healthcare providers to work together to develop a comprehensive management plan that includes these lifestyle changes. Such a plan not only aids in recovery from AKA but also contributes to long-term sobriety and health maintenance.

Treatment / Management

In general, exogenous insulin is contraindicated in the treatment of AKA, because it may cause life-threatening hypoglycemia in patients with depleted glycogen stores. In most cases, the patient’s endogenous insulin levels rise appropriately with adequate carbohydrate and volume replacement. If the patient’s blood glucose level is significantly elevated, AKA may be indistinguishable from diabetic ketoacidosis (DKA). Furthermore, individuals with AKA may also suffer from abdominal pain, nausea, vomiting, and diarrhea. The metabolic disturbances caused by AKA can lead to serious complications such as hypotension (low blood pressure), tachycardia (rapid heartbeat), and potentially fatal cardiac arrhythmias due to electrolyte imbalances.

alcoholic ketoacidosis treatment

BRENZAVVY increases the risk of life-threatening ketoacidosis in patients with type 1 diabetes. Type 2 diabetes and pancreatic disorders are also risk factors for ketoacidosis and fatal events of ketoacidosis have been reported in patients with type 2 diabetes using SGLT2 inhibitors. Signs and symptoms of diabetic ketoacidosis are consistent with dehydration and severe metabolic acidosis and include nausea, vomiting, abdominal pain, generalized malaise, and shortness of breath. Assess patients who present with signs and symptoms of metabolic ketoacidosis, regardless of blood glucose levels. If suspected, discontinue BRENZAVVY, treat promptly and monitor for resolution before restarting.

History and Physical

Ultimately, the mental health impact of AKA is a critical aspect of the condition that requires further attention and resources to ensure that individuals can recover fully and lead healthy, fulfilling lives. Beyond these specific conditions, AKA can have a general detrimental effect on nutritional status, leading to deficiencies in essential vitamins and minerals. This can further exacerbate health problems, contributing to a weakened immune system and poor wound healing, among other issues. How severe the alcohol use is, and the presence of liver disease or other problems, may also affect the outlook. It can be helpful to understand the basic guidelines for alcohol consumption so you can determine whether you are drinking above recommended levels and engaging in potentially harmful alcohol use.

  • The analysis also showed only 1 in 5 drug-related cardiac arrests were witnessed by a bystander, compared to nearly half of those due to other causes.
  • If suspected, discontinue BRENZAVVY, treat promptly and monitor for resolution before restarting.
  • He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

It is also essential to consider and address any co-occurring conditions, such as lactic acidosis or shock. A comprehensive approach, often managed by an interprofessional medical team, is vital for the effective treatment of AKA. Patients may exhibit signs of severe dehydration such as being profoundly orthostatic (symptoms that worsen upon standing) or displaying hypotension (low blood pressure), often exacerbated by decreased oral intake, excessive sweating, and vomiting. Additionally, there may be evidence of pancreatitis, which can manifest as belly pain, and nausea.

How is alcoholic ketoacidosis treated?

When this happens, it can cause ketones, which are acids, to build up in your blood. BRENZAVVY can cause intravascular volume contraction which may sometimes manifest as symptomatic hypotension or acute transient changes in creatinine. Acute kidney injury requiring hospitalization and dialysis has been reported in patients with type 2 diabetes receiving SGLT2 inhibitors. Before initiating, assess volume status and renal function in patients with impaired renal function (eGFR less than 60 mL/min/1.73 m2), elderly patients, patients with low systolic blood pressure, or patients on loop diuretics. After initiating, monitor for signs and symptoms of volume depletion and renal function.

  • The major cause of morbidity and mortality in patients diagnosed with AKA is under-recognition of concomitant diseases (that may have precipitated the AKA, to begin with).
  • In the long term, individuals may suffer from neurocognitive deficits that impair their ability to function in daily life, potentially leading to job loss, social isolation, and a deteriorating quality of life.
  • Prompt recognition and treatment of AKA are crucial to prevent serious complications and improve patient outcomes.
  • Furthermore, individuals with AKA may also suffer from abdominal pain, nausea, vomiting, and diarrhea.

Confirmation of the diagnosis includes laboratory tests that reveal metabolic acidosis with elevated beta-hydroxybutyrate levels and an increased anion gap. It is essential to differentiate AKA from other causes of metabolic acidosis, such as diabetic ketoacidosis, which is why the absence of significant hyperglycemia is a vital distinguishing factor. Since AKA can manifest after binge drinking episodes, the assessment should not be limited to chronic drinkers only.

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