Amenazas

Normally, more than 80% of the energy produced by the body is derived from the combustion of carbohydrates. If carbohydrate

reserves for energy. In addition, proteins are degraded to amino acids which in turn are converted to glucose. If excessive fat metabolism occurs in conjunction with inadequate carbohydrate metabolism, there are inadequate amounts of oxaloacetic acid with which to react with acetyl CoA from the fatty acid spiral. An excess of acetyl CoA leads to a build up of ketone bodies leading to ketosis and since ketone bodies are also acids, this leads to a condition known as acidosis. Severe acidosis, if not counteracted, can result in coma and death. A diabetic coma is accompanied by labored breathing, a dry parched mouth and tongue, acetone on the breath, a rapid pulse, low blood pressure and often vomiting.The metabolic disorders associated with diabetes mellitus are summarized in the graphic on the below.

Figure 14 . Acetone in human breath

In Another relatively easy laboratory test can be made for

ketone bodies in the urine. The condition is known as acetonuria

from the acetone present. Ketones bodies result in diabetes mellitus for the very same reasons as given for starvation. Ketone bodies are not normally found in urine nor are they present with the other types of diabetes listed. Ketone bodies are present in various amounts depending upon the severity of the diabetes mellitus.

Ketone bodies consist chemically of three substances (beta- hydroxybutyric acid, acetoacetic acid, and acetone).

When ketone bodies are released, they enter the bloodstream, acidify the blood, and are eventually excreted mostly in urine. (One type of ketone body exits via the lungs.) Without treatment, glucose and ketone bodies may build to dangerous levels in the blood. Stress and illness can increase the risk of glucose and ketone buildup. When glucose and ketone bodies build to very high levels, the following conditions then exist:

• Hyperglycemia: too much sugar in the blood.

• Ketonuria: accumulation of ketone bodies in the urine. When ketone is excreted, sodium is excreted along with it.

Ironically, ketonuria is a desired effect of a special "ketogenic diet" used to prevent or reduce the number of seizures in people with epilepsy (seizure disorders). Some physicians use this diet when conventional medications fail to control seizures or when the side effects of medications become intolerable.

The ketogenic diet, which is high in fats and low in protein and carbohydrates, mimics starvation and raises the level of ketone bodies in the blood. The ketone bodies can prevent or decrease the incidence of many types of seizures, including myoclonic (spastic) and atonic (drop) seizures. They may also limit other types of seizures, including so-called staring spells. Why ketone bodies may inhibit such seizures is not known.

The ketogenic diet is very strict and must be closely managed under a physician's supervision. Only a limited number of medical centers are equipped and trained to prescribe it.

REFERENCES

Rusman, S.Si, M.Si., dkk. 2009. Organic Chemistry Module. Bogor : SMAKBo

Denningston, K. J., Topping Joseph J. 2004. General Organic and Biochemistry. Fifth edition. USA : McGraw-Hill

Wilbraham, Antony C., dkk. 1992. Pengantar Ke Kimia Organik Hayati. Bandung : Penerbit ITB

Geissman, T. A. 1962. Principles of Organic Chemistry. USA : W. H. Freeman and Company

Busser, Herman. 1960. Pengantar Ke Kimia Organik. Bandung : Tjikapundung

Fessenden & Fessenden. 1986. Kimia Organik. Edisi ke-3 jilid 2. Jakarta : Penerbit Erlangga

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http://images.google.co.id/imglanding?q=metabolism%20human %20acetone%20diabetes %20melitus&imgurl=http://www.liveingoodhealth.info/wp- content/uploads/cc/Diabetes_mellitus76.jpg&imgrefurl=http:// www.liveingoodhealth.info/article/the-difference-between- ethanol-and- trifluoroethanol/&usg=__GrNp6dyMdBsg6OrDa_d0oISrx8Y=&h =208&w=261&sz=59&hl=id&um=1&itbs=1&tbnid=j4Sm9wb zIXwP_M:&tbnh=89&tbnw=112&prev=/images%3Fq %3Dmetabolism%2Bhuman%2Bacetone%2Bdiabetes %2Bmelitus%26um%3D1%26hl%3Did%26sa%3DX%26tbs %3Disch:1&um=1&sa=X&tbs=isch:1&start=15#tbnid=j4Sm9 wbzIXwP_M&start=19 http://www.jbc.org/content/64/1/41.full.pdf