The patient should have blood glucose checked on the initial presentation. The next important step in the management of AKA is to give isotonic fluid resuscitation. Dextrose is required to break the cycle of ketogenesis and increase insulin secretion. The dextrose will also increase glycogen stores and diminish counterregulatory hormone levels.
- People who drink large quantities of alcohol may not eat regularly.
- He was seen three weeks later in the emergency department for a similar presentation.
- Despite the frequency of abdominal symptoms, objective findings other than tenderness were infrequent.
- Meetings are widely available at little-to-no cost in most communities.
Alcohol withdrawal, in combination with nausea and vomiting, makes most patients agitated. However, if an AKA patient is lethargic or comatose, an alternative cause should be sought. It can alcoholic ketoacidosis 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.
Symptoms
Given the increasing epidemic of alcohol-related healthcare admissions, this is an important condition to recognize and we aim to offer guidance on how to approach similar cases for the practising clinician. A 49-year-old male with a history of alcohol abuse presents to the ED with complaints of generalized abdominal pain and vomiting for the last 36 hours. The patient is well-known to the department for alcohol-related visits and continues to drink daily.
If you can’t eat for a day or more, your liver will use up its stored-up glucose, which is a type of sugar. When your liver uses up its stored glucose and you aren’t eating anything to provide more, your blood sugar levels will drop. Nausea, vomiting, and abdominal pain were by far the most commonly observed complaints. Despite the frequency of abdominal symptoms, objective findings other than tenderness were infrequent. Abdominal distension, decreased bowel sounds, ascites, or rebound tenderness occurred rarely and only in the presence of other demonstrable intra‐abdominal pathology such as pancreatitis, severe hepatitis, and sepsis or pneumonia.
Differential Diagnosis
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. Cells still need energy to survive, so https://ecosoberhouse.com/ they switch to a back-up mechanism to obtain energy. Fat cells begin breaking down, producing compounds called ketones. Ketones provide some energy to cells but also make the blood too acidic (ketoacidosis).
