Why Does Ketoacidosis Only Happen To People With Diabetes?
Insulin, normally made in the pancreas, suppresses lipase, which is an enzyme that causes fat breakdown. In type 1 diabetes (DM1), there is no insulin, so the enzyme is overproduced and it causes stored fat cells to breakdown into fatty acids (acetoacidic and betahydroxybutyric) which are converted to ketones. This condition is called ketoacidosis. These ketones filter from the blood to the urine and cause a fruity smell to the urine. In type 2 diabetes (DM2), the problem is not *absence* of insulin but instead is insulin resistance (insulin is present but the cells cannot use it very well), so most DM2 patients do NOT develop ketoacidosis. Both DM1 and DM2 cause elevated blood glucose levels and the sugar passes into the urine and drags water with it, so there is increased urination. The resulting dehydration stimulates thirst. Therefore, both types have polyuria (increased urination) and polydipsia (thirst), but only DM1 will have ketoacidosis. The only other thing that causes fat breakdown is starvation. If a normal person starves him or herself, lack of carbs will cause decreased insulin levels and then lipase will cause fat breakdown. BUT, there will NOT be sugar in the urine. Continue reading >>