. Principles of modern biology. Biology. The Endocrine Glands - 409 and finally death. Clinically the picture includes a very high blood sugar level; per- sistent glucose in the urine (sometimes ap- proaching 8 percent); depletion of the gly- cogen stores of the liver; and—when the comatose stage is reached—a distinct acidosis, with detectable amounts of acetone and re- lated compounds in the blood and urine. All these symptoms point to a generalized impairment of carbohydrate metabolism in the body. In the absence of insulin the tissues of the body seem to lose their capacity to metabolize gl
. Principles of modern biology. Biology. The Endocrine Glands - 409 and finally death. Clinically the picture includes a very high blood sugar level; per- sistent glucose in the urine (sometimes ap- proaching 8 percent); depletion of the gly- cogen stores of the liver; and—when the comatose stage is reached—a distinct acidosis, with detectable amounts of acetone and re- lated compounds in the blood and urine. All these symptoms point to a generalized impairment of carbohydrate metabolism in the body. In the absence of insulin the tissues of the body seem to lose their capacity to metabolize glucose effectively, and the liver fails to store glycogen adequately. Accord- ingly, glucose accumulates in the blood and drains forth in the urine. Even if carbohy- drates are withheld from a diabetic, glucose continues to be formed and excreted. Despite the fact that the tissues cannot use it, glucose continues to be mobilized by an excessive deamination of absorbed amino acids; and even the tissue proteins are sacrificed to the same quite useless end. Fats are also oxidized to an excessive degree. This leads to a piling up of certain acidic compounds—formed as intermediary products during the excessive oxidation of the fat—at the terminal stages of acidosis. Injection of insulin alleviates the diabetic symptoms, but the action only persists for several hours. Consequently diabetics require a daily regime of insulin injections, and the maintenance of health depends upon a me- thodical adherence to the treatment—al- though rarely the endocrine tissues of the pancreas may recover their normal function. Hyperinsulinism. Unless accurately cali- brated, an injection of insulin may overshoot its mark. In this case the blood sugar level sinks drastically and hypoglycemic shock (p. 341) ensues. Therefore, most patients take precaution to have sweet drinks on hand—to be taken at first sign of "postinjection shaki- ; If shock ensues and the individual be- come
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