• Seizo Okauchi, Fuminori Tatsumi, Kaio Takahashi, Yukino Katakura, Masashi Shimoda, Kenji Kohara, Tomohiko Kimura, Atsushi Obata, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, and Hideaki Kaneto.
• Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Matsushima, Kurashiki, Japan.
• Medicine (Baltimore). 2022 Dec 16; 101 (50): e31996e31996.

BackgroundsHypoglycemic alcoholic ketoacidosis is known to be one of the emergent diseases but its frequency is very low compared to hyperglycemic ketoacidosis or hyperosmolar hyperglycemic syndrome observed in subjects with diabetes mellitus.Case PresentationWe experienced a case who had alcoholic ketoacidosis and severe hypoglycemia after drinking too much alcohol without taking enough food for a long period of time. In this subject, plasma glucose level was as low as 25 mg/dL, and ketone bodies, especially 3-hydroxybutyrate, were markedly increased. In addition, in blood gas analysis, severe acidosis was observed and anion gap was increased. These points were compatible with hypoglycemia alcoholic ketoacidosis.ConclusionsWhen we examine subjects with ketoacidosis and hypoglycemia, we should bear in mind the possibility of hypoglycemic alcoholic ketoacidosis especially in subjects who drink too much alcohol without taking enough food for a long period of time.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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