Q. Metabolic Aberrations and Symptoms?

We all know that insulin exerts an important role in the maintenance of normal blood glucose levels through its effect on the metabolism of carbohydrate, fat and proteins. Three major effects of insulin on the metabolism include:

Decreased utilization of glucose by thc body cells with a resultant increase in the blood sugar levels to ranges between 300 to 1200 mg/dl. Thus we can say that the carbohydrate metabolism gets affected and the body cells do not get the fuel for energy purposes.

Markedly increased mobilization of rats from the fat storage areas causes abnormal fat metabolism, as well as, deposition of lipids in vascular walls that cause atherosclerosis. Thus, the body depends more on energy derived from fat than that derived from carbohydrates. When this happens, the level of acetone, acetoacetic acid and hydroxybutyric acid in the body fluids rises thus causing a condition known as acidosis. A second effect which is even more important is the direct increase of ketoacids. These ketoacids have a low threshold for excretion by the kidneys. As much as 100-200 grams of ketoacids can be excreted in the urine each day. Because these are strong acids, they combine with sodium derived from the extracellular fluid replacing the extracellular fluid sodium with hydrogen ions, thereby making the urine more acidic. This causes rapid and deep breathing. These extreme effects occur in severe or poorly managed diabetes, leading to acidic coma and even death.

The third effect is on the depletion of protein in tissues of the body causing changes in the protein metabolism. The catabolic activity of muscle protein is accelerated in diabetes leading to increase in nitrogen that must be excreted after deamination. Also the cellular potassium in the blood is increased which needs to be excreted in the urine.