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[IPk] Re: going back to injections, and ketones for the brain??



Di,
I'm happy to hear that you are alright despite having to briefly go
back to injections. I have been pumping for over 7 years, and not given
myself one injection during that time. I have also had some narrow
scrapes with consumables, but so far, it has always worked out ok - I'm
pretty paranoid about having supplies available, hoard them like a
squirrel.
>Before I start, the moral of this story is "order your consumables in 
plenty 
>of time".....
....................
>Di
>PS Yes, I know I should have a backup plan for going back to 
>injections...
I not only do not have a real backup plan, but wonder if I remember how
to inject - I only ever gave myself about 5 injections with a syringe,
then used a pen (that I hope I would remember how to use in case of
need, and hope the cartridges still fit) for about 10 months before
starting pumping. If my new Cozmo pump proves as reliable as the
Disetronic pumps I have had till now, hopefully I should never need to
worry about injecting.

As for the recent comments on ketones,  
>Well, apparently, the brain actually PREFERS ketones, but gets used to

using 
>glucose.

>Lelsey 

>Adrian Miller writes: 

>> I am not sure about this! I understood that muscle tissue can use 
Ketones /
>> Fatty acids for energy but the Brain and red blood cells must have 
glucose? 
I found this weird, since it is incredibly difficult to think straight
in ketoacidosis, so I looked this up in a textbook (since my work is
about imaging metabolism, mostly glucose metabolism, I have these
things handy!), so here you have more than you probably ever wanted to
know about cerebral energy metabolism. 
Substrates of cerebral energy metabolism: - unlike most other tissues,
glucose is normally almost the only sustrate for brain energy
metabolism, and *normally* glucose is the only substrate that can
provide the brain with enough energy to maintain normal function and
structure. 
Some of the exceptions: in normal babies in the early weeks, there are
much higher amounts of ketone bodies, due to the high fat content of
human milk (also occurs in non-human mammals), and the enzymes of
ketone utilization are more active at this stage, and so the infant
brain is more efficient than the adult brain at getting energy from
ketones. 
In ketotic states (e.g. starvation - I assume this would also be on
extreme low carb high protein diet) when ketone bodies are present, the
brain will adapt to using them, and continues to function well using
the ketones. But the brain still needs some glucose (at least approx
30% of total energy requirement), and there is evidence that ketones
can never supply the entire energy requirement, so I don't know how the
statement about the brain preferring ketones would fit in.
In diabetic ketoacidosis (as opposed to starvation in non-diabetics),
there is some evidence that ketone bodies are used, but cerebral
metabolic rate is slowed due to other factors - presumably that's why
one can't think straight, and eventually goes into a coma.
I don't remember where this discussion started - was it some aspect of
pros and cons of trying extreme low carb high protein and fat diets? In
which case the real question, which has perhaps yet to be answered, is
whether being a type 1 diabetic, and having at best less than perfect
blood glucose control, would impact on the ability of one's brain to
adapt to using more ketones in place of unavailable glucose, and
whether such a diet would make one more vulnerable to develop
ketoacidosis. 
As someone who has been totally unsuccessful in sticking to a very low
carb diet for any length of time (and believe me, I've tried, with good
results for BG control, but no reduction in wish to eat carbs) the
question is interesting, but academic!
Nanette



	
	
		
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