Question

A 55-year-old man who is diabetic and alcoholic , suddenly develop respiratory distress with fruit smell breath. In the ER, his blood sugar was 257 mg/dl, arterial blood gas analysis showed severe acidosis. What could be the probable diagnosis and what metabolic pathway is deranged in this case?

Answer 1

Answer- diabetic ketoacidosis is the diagnosis , the metabolic pathway deranged is glycolysis.

,where glucose is broken down into pyruvate to release energy . Glycolysis is utilisation of glucose for cellular metabolism which reduces blood sugar levels as glucose is mobilised for the process. Insulin is the hormone which increases glucose uptake to reduce blood sugar levels . In diabetes , there is deficiency of insulin hormone so glucose is not broken down by glycolysis and builds up m decreased insulin level causes counter hormone ,glucagon to increase , glucagon increases the glucose levels in blood by increased gluconeogenesis ,which results in hyperglycemia or increased blood sugar levels . Increases lipolysis and oxidation of fats resulting in excess formation of ketoacids causing ketoacidosis.

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