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Old 01-21-2011
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Star DKA pathogenesis

Mechanisms for hyperglycemia
(1) Increased gluconeogenesis
(a) Due to increase in glucagon and epinephrine
(b) Most imp mechanism of hyperglycemia
(2) Increased glycogenolysis in the liver
Mechanism for ketone bodies
(1) Increased lipolysis with release of fatty acids
No inhibition of hormone-sensitive lipase
(2) increased (beta-oxidation of fatty acids increases production of acetyl CoA.
No malonyl Co-A to inhibit carnitine acyltransferase, the rate-limiting enzyme of beta-oxidation
(3) Acetyl CoA is converted by the liver to ketone bodies.

Acetone (fruity odor), acetoacetic and (3-hydroxybutyric acid

hope this helps
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