what ketones are?
If cells do not receive enough glucose, the body's main source of energy, ketones are molecules that the body produces. High ketone levels may signify ketoacidosis and can be found in the blood or urine. Diabetic ketoacidosis (DKA) is a serious consequence of diabetes that can result in a coma or even death in diabetic individuals. It is a disorder that affects people with type 1 diabetes more frequently, especially right after diagnosis, although it can also affect people with type 2 diabetes and anyone using certain drugs called SGLT2 inhibitors.
Are there different types of ketones?
In fact, humans contain 3 different types of ketones. The majority, or more than 80% of all ketones, is made up of beta-hydroxybutyrate (BHB). Acetoacetate (AA) and acetone, the other two ketones, make up the remainder. Although the physiology of ketone formation is intricate, it generally begins with AA, which is created during the breakdown of fatty acids. The body can use BHB as an alternative energy source because acetoacetate is swiftly converted to it in the mitochondria, primarily in the liver. Acetone is created when AA spontaneously decarboxylates, and it is partially expelled by the lungs, giving the breath a distinctively pleasant smell.
How does the body use ketones, and what is their function?
Ketone body metabolism includes ketone body synthesis, known as ketogenesis, and breakdown, or ketolysis. When the body goes from a fed to a fasted state, the liver switches from carbohydrate utilization and fatty acid synthesis to fatty acid oxidation and ketone body production. Poorly managed diabetes amplifies this metabolic transition. In this condition, the liver produces ketone bodies that enter the bloodstream and are utilised by several organs, including the brain, heart, kidneys, and skeletal muscle, to provide energy. As the brain does not have a significant source of energy that is not obtained from glucose, ketone bodies are crucial to maintaining brain function in its absence. Ketonemia is a condition where there is an elevated level of ketone bodies in the blood. Ketonemia is characterized by a high level of ketone bodies in the blood, which may occur at times of hunger, diabetes, fever, after surgery, while on a low-carbohydrate diet, or during protracted vomiting. Simply put, elevated blood levels of ketone bodies brought either by enhanced ketogenesis or impaired ketolysis result in ketonemia.
What are the risks of an increase in the concentration of ketones in the body?
Ketoacidosis may result from ketonemia, an elevated level of ketones in the blood. Diabetic ketoacidosis (DKA), which occurs when diabetic individuals lack insulin, is a particularly deadly kind of ketoacidosis. DKA can occur in diabetics receiving SGLT2 inhibitor therapy even when they are not insulin-insufficient. Alcohol, genetic, or metabolic conditions, such as a Succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency, can also cause ketoacidosis in non-diabetics. If left untreated, ketoacidosis can result in a ketoacidotic coma with potentially fatal consequences.
Could you elaborate on diabetic ketoacidosis and the precise role ketones play in the development of this condition?
As the body begins to overproduce ketone bodies, diabetic ketoacidosis, a serious consequence of diabetes, develops.
When the body lacks enough insulin to allow glucose to enter the cells, diabetic ketoacidosis develops. As a result, the body starts to break down fat as fuel instead of glucose. If left unchecked, this process causes a buildup of ketones in the bloodstream, which can eventually result in diabetic ketoacidosis. DKA is frequently brought on by an infection, sickness, or an issue with insulin therapy. The likelihood of having diabetic ketoacidosis is higher in Type I diabetes patients or those who frequently forget to take their insulin injections. The body may create more of some hormones like adrenaline or cortisol in response to an infection or other disease. These hormones work in opposition to insulin, occasionally resulting in a diabetic ketoacidosis crisis. Pneumonia and urinary tract infections are frequent illnesses that can result in DKA. Because they are not eating much, diabetes patients with gastroenteritis frequently decrease their insulin dose, which can also be a trigger. Diabetes ketoacidosis can occur in patients with poor compliance who frequently forget to take their insulin doses or who receive insufficient insulin therapy.
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