A Case of Alcoholic Ketoacidosis with Type 2 Diabetes Mellitus

• Terai Hideki

  Department of Internal Medicine, Saiseikai Kanagawa-Ken Hospital

• Hiroi Naoki

  Department of Internal Medicine, Saiseikai Kanagawa-Ken Hospital

• Kaneko Yukiyo

  Department of Internal Medicine, Saiseikai Kanagawa-Ken Hospital

• Higa Mariko

  Department of Internal Medicine, Saiseikai Kanagawa-Ken Hospital

Bibliographic Information

Other Title

• アルコール性ケトアシドーシスを合併した2型糖尿病の1例
• 症例報告 アルコール性ケトアシドーシスを合併した2型糖尿病の1例
• ショウレイ ホウコク アルコールセイ ケトアシドーシス オ ガッペイ シタ 2ガタ トウニョウビョウ ノ 1レイ

Abstract

A 64-year-old man with a history of diabetic coma was admitted for loss of consciousness and convulsions with chronic alcohol abuse, and recent binge drinking followed by abrupt cessation of alcohol and loss of appetite. Previously diabetic ketoacidosis was suspected because of his history of diabetic coma. His metabolic acidosis was corrected quickly by hydration and administration of insulin without sodium bicarbonate. Based on mild elevation of blood glucose and HbA_1C, and increasing serum ketone bodies with elevation of the ratio of β-hydroxybutyric acid to acetoacetic acid, we diagnosed his case as alcoholic ketoacidosis (AKA) with type 2 diabetes mellitus. Pathophysiologically, ethanol abuse, acute starvation, and dehydration directly cause AKA. Decreased NAD and glycogen by excessive alcohol intake and suppressed glycogenesis suppress insulin secretion. β oxidation stimulation by low insulin causes increasing levels of ketone bodies and progression of metabolic acidosis. Hydration with electrolytes and administration of glucose are the basic treatment for AKA patients without diabetes. AKA with delay in treatment or marked metabolic acidosis is frequently fatal. AKA is thus an important differential diagnosis among diabetes patients with a history of chronic alcohol abuse and metabolic acidosis.

Journal

• Journal of the Japan Diabetes Society

  Journal of the Japan Diabetes Society 49 (5), 343-348, 2006

  THE JAPAN DIABETES SOCIETY

Keywords

• アルコール性ケトアシドーシス(Alcoholic ketoacidosis)
• 2型糖尿病(type 2 diabetes mellitus)

Details

• CRID: 1390001204906133888
• NII Article ID: 10018060235
• NII Book ID: AN00166576
• DOI: 10.11213/tonyobyo.49.343
• ISSN: 1881588X
• ISSN: 0021437X
• NDL BIB ID: 7986692
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I7986692
• Web Site: https://search.jamas.or.jp/link/ui/2006314425
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • CiNii Articles
• Abstract License Flag: Disallowed