Last update and review: December 28, 2020.
A question to Gary Taubes on a social network on December 28, 2020 (slightly edited before publishing here):
Gary, so what is the mechanism of ketoacidosis? It is not quite clear in your latest book “The Case for Keto”. Can you explain it in 280 characters?
By the way, this can be a good Test of Physiological Literacy: can you explain the mechanism of ketoacidosis in 280 characters?
Here is how Gary Taubes describes ketoacidosis in his latest book “The Case for Keto”:
In diabetic ketoacidosis, fat cells dump their stored fat into the circulation, the liver wildly synthesizes ketones, and carbohydrates are not being taken up and used for fuel at anything like the rate that’s necessary. Meanwhile the liver is also generating glucose to use for more fuel. All these fuels are accumulating in the bloodstream, and pathological, metabolic hell is clearly breaking out: Ketone body levels in diabetic ketoacidosis are typically well over 20 mmol/l. This is a condition to be rightly feared, but it is an entirely different physiological state than nutritional ketosis. As I’ve said repeatedly, physicians and even the expert physicians in this field are prone to overly simplistic thinking, particularly when they are worried that harm will be done (footnote 1).
Footnote 1: Worth noting is that ketones themselves stimulate some insulin secretion, and the insulin secretion in turn inhibits ketone synthesis. This is a naturally occurring negative feedback loop that prevents ketone levels from getting pathologically high merely from changing our diets.
A Test of Physiological Literacy: can you explain the mechanism of ketoacidosis in 280 characters?
Explain the mechanism of ketoacidosis. Be as concise as possible.
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Great summary