Question

subject: physiology:

explain the pathophysiology and treatment of diabetic ketoacidosis

Answer 1

Pathophysiology of diabetes ketoacidosis:

1)Deficiency ofnInsulin :

lnsulin is produced by Beta-cells of the islets of Langerhans in response to hyperglycemia (elevated blood glucose level). Some amino acids, free fatty acids, ketonebodies, drugs such as tolbutamide also cause the secretion of insulin. Insulin is basically a hypoglycemic hormone that lowers in blood glucose level through various means. lt is an anti-diabetogenic hormone. Deficiency of insulin results in elevated blood glucose level. This causes glycosuria i.e excretion of glucose in urine which in turn causes fluid loss leading to dehydration. Also elevated blood glucose produce more acetyl coA which is diverted to produce ketone bodies.

2)Glucagon :

Glucagon is synthesized by alpha-cells of the islets of Langerhans of the pancreas. Hypoglycemia (low blood glucose level) stimulates its production. Glucagon is basically involved in elevating blood glucose concentration. lt enhances gluconeogenesis and glycogenolysis. In diabetes ketoacidosis, the level of glucagon is increased.

It is lipogenic cause mobilization of free fatty acids in the blood which is then diverted to produce ketone bodies.

Treatment of diabetes ketoacidosis :-

- Insulin therapy

- hypotonic saline

- treatment of acidosis by giving bicarbonates