On Mon, 18 Jun 2001, siobhan wrote:

> Hi all,
>
>   Every once in a while the subject of ketosis comes up.  I've wanted to
> share my opinion of it but didn't recall any references (I need a personal
> librarian, lol).  I stumbled across one of them in providing the citations
> in my recent posts.
>
>   "Dramatically increased fatty acid oxidation occurs in starvation and in
> diabetes mellitus with the large amounts of ketone bodies that accumulate to
> give the ketoacidotic condition.  Carnitine deficiency results in impairment
> of fatty acid oxidation and failure of gluconeogenesis, leading to
> hypoglycemia."

The problem here is that this quotation describes ketoacidosis,
not simple ketosis.  In a non-diabetic, ketosis does not lead to
ketoacidosis because of a feedback mechanism; i.e., when the
concentration of ketones gets to a certain level it triggers the
pancreas to release insulin to store them as fat.  In a diabetic,
of course, the insulin production mechanism is broken, so you get
runaway ketosis, which leads to acidosis.  The passage above
might lead one to believe that starvation (fasting) leads to
acidosis as well, but it doesn't, since the ketones are hastily
used as fuel, with the exception of the ones that cannot be so
used (acetone), which are excreted.  If the starvation is
accompanied by water deprivation, then there could be a problem
voiding the unusable acetone ketones while dehydrated.

Todd Moody
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