[3] Symptoms often include abdominal pain, vomiting, agitation, a fast respiratory rate, and a specific "fruity" smell.

[3] Nausea, vomiting, and abdominal pain are commonly present and people may also have tachypnea, tachycardia, and hypotension.

Chronic alcohol use can cause depleted hepatic glycogen stores and ethanol metabolism further impairs gluconeogenesis.

This can reduce glucose availability and lead to hypoglycemia and increased reliance on fatty acid and ketone metabolism.

[2] Other conditions that may present similarly include other causes of high anion gap metabolic acidosis such as diabetic ketoacidosis, toxic alcohol ingestion, and starvation ketosis.

Estimation of prevalence and outcomes of this population is limited by difficulty in diagnosing the condition and the presence of multiple disorders at presentation.

[6] In 1940, Edward S. Dillon, W. Wallace, and Leon S. Smelo, first described alcoholic ketoacidosis as a distinct syndrome.

[7] In 1971, David W. Jenkins and colleagues described cases of three non-diabetic people with a history of chronic heavy alcohol misuse and recurrent episodes of ketoacidosis.

This group also proposed a possible underlying mechanism for this metabolic disturbance, naming it alcoholic ketoacidosis.