What are ketones and why are they toxic in excess? How does DKA cause death?
In: Biology
Your brain can only use glucose as a source of energy
Insulin makes it so that glucose can enter cells so that it can be used to make energy
In T1D, the body does not make insulin so the glucose cannot enter the brain.
The body thinks that there is no glucose in the blood, so it responds by breaking down fat and using that to make energy
When too much fat is being used to make energy, the cellular machinery can become overwhelmed. To prevent a back up, some of the fat is converted into ketone bodies, which the brain can use as energy.
These ketone bodies are acidic, which makes your body more acidic and affects its functions.
The brain prefers glucose. Insulin is normally released after meals to signal fat and muscle cells to store excess glucose for later. Your liver is part of the retrieving this stored glucose, and it can also make glucose from other molecules to feed the brain during times between meals. Insulin helps tell the brain when to stop.
Type 1 diabetics don’t make insulin at all, so their livers go into overdrive making glucose. Since fat is form of stored glucose and there is no insulin to signal fat to store glucose, fat is released. Fat can be processed to ketone bodies, which your brain uses as a secondary source of fuel after it runs out of glucose. However, ketone bodies are acidic and when you have too many, the blood’s pH control system is overwhelmed and the blood becomes more acidic.
Your body can’t deal with pH outside a pretty narrow band, so once the blood is too acidic, cells don’t function as well and you start to die.
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