Diabetes is one of the complex diseases characterised by grossly abnormal fuel usage: glucose is overproduced by the liver but underutilised by other organs.
In type 1 diabetes, insulin is absent and consequently glucagon is present at high amounts than normal physiologic levels. In essence, the daibetic person is in what is usually termed, biochemical starvation mode despite a high blood glucose concentration. One major function of insulin is to increase cells' sensitivity to glucose and increase their uptake (through GLUT receptors). Because insulin is absent, the entry of glucose into cells is impaired.
The liver then becomes stuck in gluconeogenic and ketogenic mode. The excess level of glucagon relative to insullin leads to decrease in the amount of F-2,6-BP in the liver, hence glycolysis is inhibited and gluconeogenesis is stimulated because of the complementary effects of F-2,6-BP on PFK and FBPase.
Because carbohydrate utilisation is impaired, a lack of insulin leads to the uncontrolled breakdown of lipids and proteins. However, breakdown of lipids generate more acteyl CoAs which cannot enter citric acid cycle (why?); instead, ketone bodies are produced.
This ecplains why Diabetic patients usually suffer a biochemical condition called, Diabetic Ketoacidosis. Coma is highly to occur simply because of the severely lowered blood PH (same effect that will happen if you were put in an enclosed place full of CO2).
Before we can tackle this essential topic, let's skim through the ketone bodies production pathway. This pathway basically occurs in the liver.
After about 3 days of starvation, the liver forms large quantities of acetoacetate and D-3-hydroxybutyrate (ketone bodies). Their synthesis from acetyl CoA increases markedly because the citric acid cycle is unable to oxidize all the acetyl CoA units generated by the degradation of fatty acids. Gluconeogenesis (a pathway that ensures supply of glucose to non-gluconeogenic organs) depletes the supply of oxaloacetate, which is essential for the entry of acetyl CoAs into the citirc acid cycle.
Consequently, it's more prudent that the liver produces large amounts of ketone bodies, which must be released into the blood. At this time the brain begins to consume appreciable amount of acetoacetate in place of glucose.
After several weeks of starvation, ketone bodies become the main fuel of the brain, insinuating that the synthesis of glucose from non-glucose molecules be halted or minimised.
This natural feedback actually saves the conversion of more muscle tissue into glucose, thus reducing the amount of muscle tissue being degraded.
STARVING FOR WEEKS WON'T KILL YOU!!!
Wait on me, my princess. My timing is always perfect.
I know you are anxious about many things, and I see your passion for all the plans
I have put in your heart. I know that you long to fly, and I see your enthusiasm. However,
just as a vinedresser nurtures the vine and waits patiently for the right moment to
harvest the grapes, so too am I working tirelessly to prepare you to bear much fruit.
Don't run ahead of me or try to fly before my plans are complete. Draw close tome now, and
I promise that this season of waiting will bring you the sweetest of rewards.
Your currency of life.
When all is said,
then the question,'who will?' arises.
We are always ready to assess,
but not ready to take initiatives.
We always imagine and dream big,
but have we ever been able to create?
when is all our dreams coming to an end?
'Your imagination is your creation',
so goes the line of a track.
But can illusions come into reality without initiation?
That leaves us with the big question,
'When all is said, who will?'
In a garden are flowers
in the periphery,
with different scents and colours,
but my soul did pine to one, 'long stemmed red rose'.
How i wish i could groom this flower to make it mine forever,
but it had an ambiguous fragrance
that put thine in the reposer position.
The world would utter,
'time and tide wait for no man',
but i just can wait to have this flower
to groom and make it mine forever.