Ketone Bodies (Part 4 of 4) - Diabetes, Starvation, and Ketoacidosis
In this video, I describe how buildup of Ketone Bodies and their association with Diabetes, Starvation, and Ketoacidosis.
Over-production of ketone bodies is very bad because ketone bodies are acidic. If ketone bodies build up, that’s called Ketosis. If the pH of the blood becomes too acidic, that’s called Acidosis. When ketone bodies build up in the blood, they acidify the blood, causing the pH to drop. A drop in blood pH due to an increased concentration of ketone bodies in the blood is called Ketoacidosis, which is potentially lethal.
During starvation, the body relies heavily on stored fat for energy. Triglycerides are broken down to glycerol and fatty acids, and fatty acids are broken down to Acetyl-CoA molecules via Beta Oxidation. The Acetyl-CoA molecules are supposed to go through the Krebs Cycle, but they do not go through as they would normally because gluconeogenesis is active during starvation. This draws oxaloacetate (OAA) out of the mitochondrial matrix (by way of malate) into the cytosol of the cell. Thus, OAA is not available to combine with Acetyl-CoA in the first step of the Krebs Cycle. So, a great deal of Acetyl-CoA builds up and is diverted to Ketogenesis, producing many ketone bodies at a rapid rate. These ketone bodies are sent in the blood to extrahepatic tissues, but the extrahepatic tissues cannot oxidize the ketone bodies quickly enough to keep up with the supply coming from the blood. Thus, ketone bodies build up in the blood – ketoacidosis.
With Type I Diabetes, patients do not produce enough insulin (or any insulin). So, their cells cannot take up glucose from the blood. Thus, gluconeogenesis is active, doing all of the same things as it does in starvation, yielding the same result, ketoacidosis. Type I Diabetes is sometimes referred to “starvation amongst plenty” because of the way a patient can essentially starve and die from ketoacidosis, even though they’ve got plenty of glucose in their blood; they just can’t use it.
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