Alcoholic Starvation Ketoacidosis

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Postmortem Diagnosis Of Alcoholic Ketoacidosis | Alcohol And Alcoholism | Oxford Academic

Aims: The aim of this article is to review the forensic literature covering the postmortem investigations that are associated with alcoholic ketoacidosis fatalities and report the results of our own analyses. Methods: Eight cases of suspected alcoholic ketoacidosis that had undergone medico-legal investigations in our facility from 2011 to 2013 were retrospectively selected. A series of laboratory parameters were measured in whole femoral blood, postmortem serum from femoral blood, urine and vitreous humor in order to obtain a more general overview on the biochemical and metabolic changes that occur during alcoholic ketoacidosis. Most of the tested parameters were chosen among those that had been described in clinical and forensic literature associated with alcoholic ketoacidosis and its complications. Results: Ketone bodies and carbohydrate-deficient transferrin levels were increased in all cases. Biochemical markers of generalized inflammation, volume depletion and undernourishment showed higher levels. Adaptive endocrine reactions involving insulin, glucagon, cortisol and triiodothyronine were also observed. Conclusions: Metabolic and biochemical disturbances characterizing alc Continue reading >>

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  1. PinkCupcake

    Fever can be a later symptom which would cause the warm skin and usually when people have a fever they "feel" cold.

  2. KatePasa

    Hot and dry, sugar's high. (Hyperglycemia) Cold and clammy, need some candy. (Hypoglycemia)

  3. garnetgirl29

    Oh that's a great way to remember it KatePasa! Thanks!
    In DKA, will the person feel cold even tho their skin is hot to anyone who touches them? Just trying to understand why my sister said she was cold when her sugar was high. (but, she doesn't have a pancreas at all, so her case is extreme)

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high b

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a metabolic complication of alcohol use and starvation characterized by hyperketonemia and anion gap metabolic acidosis without significant hyperglycemia. Alcoholic ketoacidosis causes nausea, vomiting, and abdominal pain. Diagnosis is by history and findings of ketoacidosis without hyperglycemia. Treatment is IV saline solution and dextrose infusion. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. Alcohol diminishes hepatic gluconeogenesis and leads to decreased insulin secretion, increased lipolysis, impaired fatty acid oxidation, and subsequent ketogenesis, causing an elevated anion gap metabolic acidosis. Counter-regulatory hormones are increased and may further inhibit insulin secretion. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs. Diagnosis requires a high index of suspicion; similar symptoms in an alcoholic patient may result from acute pancreatitis, methanol or ethylene glycol poisoning, or diabetic ketoacidosis (DKA). In patients suspected of having alcoholic ketoacidosis, serum electrolytes (including magnesium), BUN and creatinine, glucose, Continue reading >>

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  1. Margot LaNoue

    A few methods:
    - pee on a stick. There's a generic brand (I use Walgreen's) and the official brand. In general, they're called "ketone test strips" and they will change colors depending on the amount of ketone bodies in your urine. There is no "perfect level" of ketone bodies; you are either in ketosis or you are not. You will find these test strips in the same isle as the diabetic test stuff.
    - smell your breath. It will smell *awful* because a side product of ketosis is acetone in the urine and breath. While urine might always smell bad to you, your breath will smell truly, noticeably foul.
    - no bloating. Ketones do not bind with water the way glucose/glycogen does. You will not retain water when in ketosis. Nice!

  2. Cherie Nixon

    Warning: this might gross you out, but there's a simple answer to this question.
    OK, you want to know how you can tell? If you're in ketosis, you will often find oily residue floating in the toilet (assuming adequate lighting to see it). That's because while in ketosis, you excrete excess fat calories.

  3. Gary Wayne Nettoc

    The taste that people have mentioned is from the acetone in your breath, produced when you are in ketosis. There's a cool gadget that can measure that and let you know if you are in ketosis. KETONIX by Moose AB, Org.nr 556443-3794 It doesn't require strips or any replacement parts so in the long run it is the cheapest alternative.

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Insulin Drip In Euglycemic Ketoacidosis - A Tough Nut To Crack!

Abstract: This abstract also was presented at the 15th annual Rachmiel Levine Diabetes and Obesity Symposium on March 2, 2015, Levine Poster Number: 39. Background: Metabolic ketoacidosis has been frequently associated with three major etiologies which include diabetes, alcohol and starvation. Treatment is tailored towards the cause and usually involves crystalloid infusion in alcohol and starvation ketosis and implementation of insulin drip in diabetic ketoacidosis[1]. On the contrary our patient presents with a challenging scenario which warrants further insight to the treatment strategies of metabolic ketoacidosis. Clinical Case: A 59-year-old male with past medical history of diabetes and alcoholism presented to the ER with coffee ground emesis for 3 days. One week prior to admission the patient fell off the stairs and injured his left shoulder. Thereafter he consumed alcohol for pain relief and had not eaten anything. He admits to not taking his insulin for last 2 days. Upon admission vitals were stable. His labs were significant for Hb- 10.4 (n 11.6-16.8) g/dL, INR- 1.0 (n 0.9-1.1), blood glucose- 106 (n 70-115) mg/dL, BUN- 15 (n 6-20) mg/dL, Cr- 0.6 (n 0.7-1.2) mg/dL, Na- 13 Continue reading >>

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  1. AngelaR

    Later in January it will be time for my annual physical. The doc wants to do bloodwork and cholesterol testing. He is not supportive of LC...he is a low fat fanatic with me because of the severe gall bladder attacks I was having 4 years ago. I have not mentioned to him that I was LCing, but the last time I saw him I mentioned that I was "eating healthier" His response was "ahh, low fat, you finally got the message"
    If I am in ketosis when the bloodwork is done (or the urine sample), will it show up in the tests? I know this is a broad question because there are a lot fo different tests that are done on blood and urine. He will be checking mostly for cholesterol, and probably redoing the test for hormones because I am pre-menopausal.
    I don't want to have to justify how I am eating to the man who was only interested in prescribing drugs to fix all the post gall bladder surgery problems I had (which by the way have disappeared since I started LCing)
    I bought a bottle of Ketostix just for kicks a while back, rarely use them, and have never registered more than trace ketosis.

  2. Natrushka

    Yes, Angela. It will show up in the urine sample. I had mine tested back in September and when I got the results back I saw the 1.5 reading for Ketones in the urine (small / trace).
    This might be a good time to let him know what you're doing. You've lost weight, you're feeling good, he's pleased with your progress so far? If all your blood work is glowing then maybe it's time to let him know just how wrong he's been?
    Alternatively, because you're fasting you can't eat 12 hours before the test, but you can drink water. You should be able to dilute the concentration a bit, but I think there will still be a trace element left. Exercising the day before and drinking a few litres of water would help lessen the amount though.

  3. doreen T

    No doubt, you will be in a fasting state -- 8 to 12 hrs is required for fasting blood sugar, cholesterol and triglycerides. You would be wise to drink lots of water during this fasting time, especially on rising the morninig of the tests. No coffee or caffeine for 18 hrs prior -- they don't tell you this, but it can alter the triglyceride readings.
    Any ketones present in the urine will be detected during the routine urinalysis. But unless your urine is concentrated, or you've eaten a fatty meal a few hours prior to the test, I seriously doubt that there will be more than a trace present. As a nurse, I can tell you this is considered normal, especially if the dr. considers that you have been fasting Note - routine urinalysis is done by the nurse right there in the office, using a dipstick just like the ketone strips ... but having 5 or more reactive pads on it, to test for different things -- pH (should be slightly acidic), specific gravity (how concentrated it is) , glucose, ketones and protein. Eating protein won't lead to protein in the urine unless your kidneys are diseased or your liver is unable to break down the amino acids. Protein in the urine usually indicates infection, or kidney disease.
    Blood tests are expensive, so unless the doc. specifically orders for serum ketone levels to be checked, then it's not going to be looked for .. Just as for the urine test ... it's considered normal for there to be some ketones present while in a fasting state -- for all persons, not just low-carbers.
    My 2¢ - Getting back the blood reports and having them be improved from previous (or perfectly normal if never checked before) would be a good time to tell your dr. that you are following a carb-controlled program. Especially since you've successfully lost weight as well. That's why I did ... my doc was skeptical at first, but impressed with improved bloodwork, lowered blood pressure and lbs lost ... plus I showed her some sample menus of what I was eating. When she saw the salads, vegetables and lean meats, olive oil .. and no chips, cookies or white bread ... she softened her view, and has been very supportive ever since.
    Doctors are just a susceptible as anybody to the public mythology and media, which depicts Atkins and low carb as eating huge fatty steaks and cheese, with great gobs of lard and bacon by the slab ... and nothing else.
    Good luck to you!

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