Reference no: EM132441428

Cell Metabolism Gone Bad

Bob, a 63-year-old white male, has been feeling more fatigued than normal for the last few weeks. He describes his breathing as "funny." He breathes rapidly, as though he is trying to get rid of something through his lungs. He is dizzy and his breath has a chemical, almost "boozy" smell. He has been stopped twice for DUIs, but has not had an alcoholic drink in months.

Bob's metabolism is not working. He is having problems maintaining the proper pH in his blood and tissues, and he is trying to get rid of a mixture of chemical wastes called ketones. He has type 1 diabetes mellitus. He is not producing an adequate supply of a pancreatic hormone called insulin. Insulin is required by three tissues in his body: the liver, muscles, and adipose (fat) tissues. These are the tissues that use and store carbohydrates. If these tissues cannot get sugars, they call on the body's supply of fats and burn the energy contained in triglycerides.

Because humans also require a vitamin to help transport metabolites to mitochondria, we can run into trouble if there is an excess breakdown of the fatty acids in the fats. Acetyl groups form, which must be picked up by coenzyme A for transportation. If the fatty acids are not picked up, they form acid wastes called ketones; these will force the body into metabolic acidosis and will cause death if the condition is not reversed. The respiratory system will try to compensate by increasing the expulsion of carbon dioxide. The ketones, especially acetone, will come out in the breath. The other symptoms are all related to the acid condition. Normal amounts of insulin prevent these events from occurring.

Questions

1. How can diabetes be detected?

2. Is it necessary for all individuals with diabetes require insulin?