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Subsequently, she was found to have acidosis caused by acute or chronic alcohol consumption, even though her serum glucose was higher than would be typically expected with alcohol abuse. Alcoholic ketoacidosis usually has lower glucose levels as well as retained mental function when compared with DKA. A haemoglobin A1c, fructosamine level, betahydroxybutyrate to acetoacetate ratio, C-peptide and antibodies to pancreatic beta-cells can help rule out diabetes as the aetiology of the ketoacidosis. This patient was treated with fluids and electrolyte replacement, showed rapid improvement, received alcohol cessation resources and was discharged home.<\/jats:p>","DOI":"10.1136\/bcr-2024-260627","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T13:05:25Z","timestamp":1731416725000},"page":"e260627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Alcoholic ketoacidosis: confused diagnosis"],"prefix":"10.1136","volume":"17","author":[{"given":"Patrick Carlsen","family":"Smith","sequence":"first","affiliation":[{"name":"Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Neutze","sequence":"additional","affiliation":[{"name":"Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"2025082711592427000_17.11.e260627.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp042262"},{"key":"2025082711592427000_17.11.e260627.2","unstructured":"National Institute on Alcohol Abuse . 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