Lu W T, Chen K W, Lin J D, Huang H S, Lee C R, Huang R S
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1997 Mar;20(1):34-8.
Heavy alcohol intake (> 45 g daily) might be a cause of diabetes. The short-term risks of heavy alcohol intake include ketoacidosis, glucose intolerance and pancreatitis. Alcoholic ketoacidosis (AKA) in combination with hyperglycemia mimics diabetic ketoacidosis (DKA). We described the characteristics of heavy drinkers with ketoacidosis and hyperglycemia but without a prior history of diabetes.
Twelve habitually heavy drinkers who had not been previously diagnosed as diabetes were identified by reviewing the records of diabetic patients admitted to Chang Gung Memorial Hospital from 1989 to 1992. All of them met DKA criteria.
Elevated glycohemoglobulin (HbAlc) level is an indicator for the diagnosis of diabetes. Among these 12 patients, 10 had elevated levels of HbAlc and 2 had normal HbAlc levels. Of these 2 patients, 1 had an elevated level of HbAlc 6 months later; the other who was a female who after observation, had normal levels of HbAlc and glucose for the follow-up of two years.
We found that most heavy drinkers with both ketoacidosis and hyperglycemia also had diabetes as indicated by high levels of HbAlc. The only female patient had normal HbAlc and was diagnosed as AKA rather than DKA.
大量饮酒（每日超过45克）可能是糖尿病的一个病因。大量饮酒的短期风险包括酮症酸中毒、葡萄糖耐量异常和胰腺炎。酒精性酮症酸中毒（AKA）合并高血糖类似于糖尿病酮症酸中毒（DKA）。我们描述了患有酮症酸中毒和高血糖但既往无糖尿病史的重度饮酒者的特征。
通过回顾1989年至1992年入住长庚纪念医院的糖尿病患者记录，确定了12名既往未被诊断为糖尿病的习惯性重度饮酒者。他们均符合DKA标准。
糖化血红蛋白（HbAlc）水平升高是诊断糖尿病的一项指标。在这12例患者中，10例HbAlc水平升高，2例HbAlc水平正常。在这2例患者中，1例6个月后HbAlc水平升高；另1例为女性，观察两年后HbAlc和血糖水平正常。
我们发现，大多数同时患有酮症酸中毒和高血糖的重度饮酒者，其HbAlc水平升高表明也患有糖尿病。唯一的女性患者HbAlc正常，被诊断为AKA而非DKA。
