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Etiology Of Abdominal Pain In Dka

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What Is The Origin/mechanism Of Abdominal Pain In Diabetic Ketoacidosis?

Other than all papers I could find citing the depth of the keto-acidosis (and not the height of the blood glucose levels) correlating with abdominal pain, nothing else to explain how these two are linked. Decades ago, I was taught that because of the keto-acidosis causing a shift of intracellular potassium (having been exchanged for H+ protons of which in keto-acidosis there were too many of in the extracellular fluid) to the extracellular, so also the blood compartment, resulting in hyperkalemia, paralyzing the stomach, which could become grossly dilated - that’s why we often put in a nasogastric drainage tube to prevent vomiting and aspiration - and thus cause “stomach pain”. This stomach pain in the majority of cases indeed went away after the keto-acidosis was treated and serum electrolyte levels normalized. In one patient it didn’t, she remained very, very metabolically acidotic, while blood glucose levels normalized, later we found her to have a massive and fatal intestinal infarction as the underlying reason for her keto-acidosis….. Continue reading >>

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  1. Veretiel

    Don't take it the wrong way, I don't try to offend anyone. I'm just a bit curious and would love if you enlighten me up.
    From what I read, your brain could only receive energy from carbs. So when people go ketogenic and lower massively they carbs, where they get the energy for thinking?

    I'm not trying to say that they don't use the brain or don't think much. I'm just wondering how it works.

  2. nwthomas

    During ketosis the liver uses fat to produce chemicals called ketone bodies, which can provide energy to many types of tissues which would otherwise take glucose. The brain can adapt to get about 75% of its energy from ketone bodies. The remaining 25% must come from glucose. If the person is still ingesting a little bit of carbs, these will mostly go to the brain. If they aren't ingesting enough carbs to meet the brain's needs, the liver will transform protein into glucose through a process called gluconeogenesis.

    Anecdotally
    9 some people report feeling tired and mentally sluggish when in ketosis, while other people report that they actually feel more alert and mentally acute. I don't think anybody really knows why that would happen.

  3. Veretiel

    Thank you.
    It's amazing how the body adapts to different situations.

    I suppose that puts an extra stress on the liver, so what are the benefits of ketosis?

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