Summary
Ketoacidosis is not always diabetic
Piulats Egea N, Flores Le Roux JA, Puig De Dou J, Chillarón Jordán JJ
Affiliation of the authors
Medicina Familiar y Comunitaria. Servicio Endocrinología y Nutrición. Hospital del Mar, Barcelona. Spain.
DOI
Quote
Piulats Egea N, Flores Le Roux JA, Puig De Dou J, Chillarón Jordán JJ. Ketoacidosis is not always diabetic. Emergencias. 2010;22:290-2
Summary
Alcoholic ketoacidosis presents with nausea, vomiting, and abdominal pain in chronic
alcoholics who drink a larger amount of alcohol than usual just before onset.
Biochemically this condition is characterized by metabolic acidosis with a high anion
gap, ketosis with a high ratio of â-hydroxybutyrate, and a glucose level that is low,
normal or only slightly elevated. The main differential diagnosis is diabetic ketoacidosis.
Treatment involves thiamine and carbohydrate replacement. Although the use of insulin
is controversial, some patients, such as the one whose case we report, require insulin to
correct hyperglycemia secondary to glucose overload.