Ketoacidosis - Pathophysiology

Pathophysiology

Ketoacidosis occurs when the body is producing large quantities of ketone bodies via the metabolism of fatty acids (ketosis) and the body is producing insufficient insulin to slow this production. The excess ketone bodies can significantly acidify the blood. The presence of a high concentration of glucose in the blood (hyperglycemia) caused by the lack of insulin can lead to further acidity. In healthy individuals this normally does not occur because the pancreas produces insulin in response to rising ketone/blood glucose concentration.

Acidity results from the dissociation of the H+ ion at physiological pH of metabolic ketone bodies such as acetoacetate, and β-hydroxybutyrate.

Acetone has no easily liberated proton, and is thus non-acidic in human biochemical environments.

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