Explain why individuals with type 1 diabetes can suffer serious complications during ketosis.
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In type 1 diabetes, little to no insulin is produced. This lack of insulin does not allow for normal carbohydrate and fat metabolism. Without sufficient insulin, cells cannot readily utilize glucose, resulting in rapid lipolysis and the excess production of ketone bodies. If the concentration of ketone bodies rises too high in the blood, they spill into the urine, pulling the electrolytes sodium and potassium with them. Eventually, severe ion imbalances occur in the body. The blood also becomes more acidic because 2 of the 3 forms of ketone bodies contain acid groups. The resulting condition, known as diabetic ketoacidosis, can induce coma or death if not treated immediately, such as with insulin, electrolytes, and fluids (see Chapter 5). Ketoacidosis usually occurs only in ketosis caused by uncontrolled type 1 diabetes; in fasting, blood concentrations of ketone bodies typically do not rise high enough to cause the problem.
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