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Alcoholic detosis

M Fulop, H D Hoberman

    Diabetes
    |September 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Alcoholic ketoacidosis is often linked to starvation in chronic alcohol abusers. Treatment with glucose and saline is typically effective, with ketoacidosis itself rarely being fatal.

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    Area of Science:

    • Internal Medicine
    • Biochemistry
    • Critical Care Medicine

    Background:

    • Alcoholic ketoacidosis (AKA) is a metabolic complication in chronic alcohol abusers.
    • AKA is characterized by ketonemia or ketonuria with little or no glucosuria.
    • Previous reports suggest severe acidemia is common in AKA.

    Purpose of the Study:

    • To investigate the clinical features and pathogenesis of suspected alcoholic ketoacidosis.
    • To differentiate AKA from other acid-base disorders in alcohol abusers.
    • To evaluate the role of starvation and alcohol intake in AKA development.

    Main Methods:

    • Retrospective analysis of 24 chronic alcohol abusers hospitalized over 27 months.
    • Measurement of plasma 3-hydroxybutyrate levels.

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  • Assessment of acid-base status, glucose levels, and patient history regarding alcohol intake and nutrition.

    • Main Results:

    • Twenty-one patients presented with moderate to severe ketosis (plasma 3-hydroxybutyrate 5.2–22.5 mmol/L).
    • Fifteen patients were not diabetic; six had mild postprandial hyperglycemia.
    • Three patients primarily had lactic acidosis, not AKA. Severe acidemia was uncommon; seven were alkalemic.
    • Poor nutrition and decreased alcohol intake preceded presentation. Ketosis resolved rapidly with glucose and saline treatment.
    • No deaths were directly attributed to ketoacidosis.

    Conclusions:

    • Acute starvation is a significant factor in the pathogenesis of alcoholic ketoacidosis.
    • Severe acidemia is not a universal feature of AKA.
    • Treatment with glucose and saline is generally effective, and interventions like insulin or sodium bicarbonate may not always be necessary.