Step I Ketoacidosis in T2DM

[TheDonDc]

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Hi,

I was wondering why it is rare that people with type 2 diabetes get ketoacidosis.

If their cells are being deprived of insulin sensitivity, why are the symptoms not the same as type 1 diabetes?

 

[animando]

because their cells have less sensitivity to insulin, not 0% though.

 

[solitarius]

^ Actually, it's b/c there's zero production of insulin in T1, while diminishing levels in T2.

 

[Jabbed]

Dime store logic is that the basal level of production of insulin is able to prevent the development of clinically significant ketoacidosis through direct inhibition of lipolysis/ketogenesis at hormone-sensitive lipase. Recall that hormone sensitive lipase is inhibited by insulin and stimulated by stress hormones. The conditions are virtually identical however in that there is still marked intracellular hypoglycemia and marked extracellular hyperglycemia. Insulin therapy is important in the treatment of both conditions.

 

[TheDonDc]

alright, thanks. that cleared it up

 

[seminoma]

^ Actually, it's b/c there's zero production of insulin in T1, while diminishing levels in T2.

This isn't true. Early in T2 there is increased secretion of insulin as the beta cells try to compensate for insulin resistance.

The reason DKA is so infrequent in T2 is that lipolysis, compared to glucose uptake, is much more sensitive to insulin.

 

[solitarius]

This isn't true. Early in T2 there is increased secretion of insulin as the beta cells try to compensate for insulin resistance.

The reason DKA is so infrequent in T2 is that lipolysis, compared to glucose uptake, is much more sensitive to insulin.

Do you disagree that it's a production? Or are you just mentioning that insulin increases before decreasing in T2?

 

[seminoma]

Do you disagree that it's a production? Or are you just mentioning that insulin increases before decreasing in T2?

Just mentioning that it increases before decreasing. I think it's important to recognize that T2DM is an insulin resistance issue regardless of the insulin level.