Abstract
Ketones are acetone, acetoacetic acid (acetoacetate), and β-hydroxybutyric acid (BHB). Of these, only acetoacetetate and BHB cause acidosis, whereas acetone does not cause acidosis. Acetone is formed by nonenzymatic decarboxylation of acetoacetate and does not contribute any acid load to the body (Fig. 32.1). Clinically, metabolic acidosis due to ketone overload is caused by diabetes, alcohol, and starvation. Therefore, this chapter focuses on diabetic, alcoholic, and starvation ketoacidosis.
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Suggested Reading
Adrogué HJ, Madias NE. Diabetic and other forms of ketoacidosis. In: Gennari FJ, Adrogué HJ, Galla JH, Madias NE, editors. Acid–base disorders and their treatment. Boca Raton: Taylor & Francis; 2005. p. 313–50.
Dhatariya KK, Velllanki P. Treatment of diabetic ketoacidosis (DKA)/hyperglycemic hyperosmolar state (HHS): Novel advances in the management of hyperglycemic crises (UK versus USA). Curr Diab Rep. 2017;17:33.
Fayfman M, Pasquel FJ, Umpierrez GE. Management of hyperglycemic crises. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Med Clin N Am. 2017;101:587–606.
Goldenberg RM, Berard LD, Cheng AYY, et al. SGLT2 inhibitor-associated diabetic ketoacidosis: Clinical review and recommendations for prevention and diagnosis. Clin Thrapeut. 2016;38:2654–64.
Inward CD, Chambers TL. Fluid management in diabetic ketoacidosis. Have we got it right yet? Arch Dis Child. 2002;86:443–5.
Joint British Societies Inpatient Care Group. The management of diabetic ketoacidosis in adults. 2nd ed, Update: Sept 2013, p1-43.
Kamel KS, Halperin ML. Acid–base problems in diabetic ketoacidosis. N Engl J Med. 2015;372:346–54.
Kamel KS, Schreiber M, Carlotti APCP, et al. Approach to the treatment of diabetic ketoacidosis. Am J Kidney Dis. 2016;68:967–72.
Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1333–43.
Long B, Lentz S, Gottlieb M. Alcoholic ketoacidosis: Etiologies, evaluation, and management. J Emerg Med. 2021;61:658–65.
McGuire LC, Cruickshank AM, Munro PT. Alcoholic ketoacidosis. Emer Med J. 2006;23:417–20.
Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65:507–21.
Pasquel FJ, Umpierrez GE. Hyperosmolar hyperglycemic state: A historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care. 2014;37:3124–31.
Rosenstock J, Ferrannini E. Euglycemic diabetic ketoacidosis: A predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diabetes Care. 2015;38:1638–42.
Tran TTT, Pease A, Wood AJ, et al. Review of evidence for adult diabetic ketoacidosis management protocols. Front Endocrinol. 2017;8:1–13.
Wrenn KD, Slovis CM, Minion G, et al. The syndrome of alcoholic ketoacidosis. Am J Med. 1991;91:11928.
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Reddi, A.S. (2023). Diabetic, Alcoholic, and Starvation Ketoacidosis. In: Fluid, Electrolyte and Acid-Base Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-25810-7_32
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DOI: https://doi.org/10.1007/978-3-031-25810-7_32
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