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May 15, 2000


Question from Santa Rosa, California, USA:

Your information on insulin includes this: Ketones are excreted in the urine along with sodium bicarbonate, which results in a decrease in the pH of the blood. This condition is called acidosis. To correct the acidosis, the body begins a deep, labored respiration, called Kussmaul’s respiration. How does the Kussmaul’s respiration alleviate the acidosis, and is the diabetic’s body able to adequately replace the sodium bicarbonate lost? I am also wondering if the pancreatic digestive enzymes such as secretin are in good stores in diabetics.


Pancreatic digestive enzymes are not disturbed in autoimmune diabetes; but, of course, they may be in malnutrition or pancreatitis induced diabetes. Changes in respiratory tidal volume control blood acid base balance by controlling carbon dioxide excretion. This later when combined with water in the presence of carbonic anhydrase forms carbonic acid.