GRACE M10 - Fasting and Ketoacidosis Flashcards
Increase ___ and ___ to provide substrates for fuels
-proteolysis and lipolysis
amino acids and glycerol for liver gluconeogenesis and fatty acids for beta oxidation and for ketogenesis to make ketone bodies
Increased G:I ratio activates ____ enzymes rapidly = glycogen is gone in about ___ days
glycogenolysis , 1.5 days
Increased G:I ratio increases ____ slowly to peak at ____ days (increase substrates and lipolysis to glycerol)
gluconeogenesis , 2-3 days
-By day ____ of a fast, brain starts to use ketone bodies in place of glucose
-By day ____, KB use = ~glucose use
-By ____, KB = 2/3 (max) and glucose = 1/3
3, 7, 2 wks
Normal hepatic glucose production and fall in body glucose use usually maintain enough plasma [glucose] during fasting to prevent _____
clinical hypoglycemia
During fasting, low glucose = ____ glucagon and ____ insulin
increase glucagon and decrease insulin
but increase in plasma KB = mildly increase insulin = G:I ratio plateaus = adipose lipolysis plateaus = substrate generation for ketogenesis slows and [KB] doesn’t rise enough to cause a problem
Diabetic ketoacidosis (DKA): life-threatening ketoacidosis with hyperglycemia
o Maximum G:I ration drives maximum cellular fuel production = ketogenesis and hepatic glucose production
o Maximum ketogenesis and bicarb loss cause life-threatening ketoacidosis
Alcoholic ketoacidosis (AKA): ketoacidosis with hypoglycemia
Ethanol metabolism inhibits gluconeogenesis and promotes ketogenesis during fasting to cause hypoglycemia
Alcoholic ketoacidosis
-NADH decreases conversion of ____ required for to a gluconeogenesis
-NADH decreases use of ___ in gluconeogenesis and instead causes liver to secrete ____
-glycerol to intermediate
-lactate x2
Ethanol withdrawal amplifies fasting ____ to cause ketoacidosis
fasting G:I ration and ketogenesis
Classic AKA includes ___ days with no food or fluid intake = ____ epinephrine secretion and alcohol metabolism in liver explain dramatic decrease in plasma glucose and increase in plasma
1-2 days
-increased epi