reduced
effective insulin concentrations and increased
concentrations of counterregulatory
hormones (catecholamines, cortisol,
glucagon, and growth hormone) lead to
hyperglycemia and ketosis. Hyperglycemia
develops as a result of three processes:
increased gluconeogenesis,
accelerated glycogenolysis, and impaired
glucose utilization by peripheral tissues
(12–17). This is magnified by transient
insulin resistance due to the hormone imbalance
itself as well as the elevated free
fatty acid concentrations (4,18). The
combination of insulin deficiency and increased
counterregulatory hormones in
DKA also leads to the release of free fatty
acids into the circulation from adipose tissue
(lipolysis) and to unrestrained hepatic
fatty acid oxidation in the liver to ketone
bodies (-hydroxybutyrate and acetoacetate)
(19), with resulting ketonemia and
metabolic acidosis.
reduced
effective insulin concentrations and increased
concentrations of counterregulatory
hormones (catecholamines, cortisol,
glucagon, and growth hormone) lead to
hyperglycemia and ketosis. Hyperglycemia
develops as a result of three processes:
increased gluconeogenesis,
accelerated glycogenolysis, and impaired
glucose utilization by peripheral tissues
(12–17). This is magnified by transient
insulin resistance due to the hormone imbalance
itself as well as the elevated free
fatty acid concentrations (4,18). The
combination of insulin deficiency and increased
counterregulatory hormones in
DKA also leads to the release of free fatty
acids into the circulation from adipose tissue
(lipolysis) and to unrestrained hepatic
fatty acid oxidation in the liver to ketone
bodies (-hydroxybutyrate and acetoacetate)
(19), with resulting ketonemia and
metabolic acidosis.
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