Quaint old journal article on endocrine crises :)

Diabetic Ketoacidosis

Pathophysiology: Starvation in the midst of plenty

The Actors in the drama:
-Insulin
-Glucagon
-Free fatty acids: Essential for the play to begin
-Glucose transporters: Playing supporting roles in developing hyperclycemia

The Stage:
Scene I, The Fat cell: Insulin exits and the fat cells goes into lipolysis
Scene II, The Liver: Glucagon enters and the liver becomes a sugar and ketoacid factory
Scene III, The Kidney: Osmotic diuresis leads to dehydration
Scene IV, Skeletal Muscle: Potassium moves out of the cells

The Patient is the Star:

'The patient never stops making water and the flow is incessant... life is short, unpleasant and painful, thirst unquenchable, drinking excessive... if for a while they abstain from drinking, their mouths become parched and their bodies dry; the viscera seem scorched up; the patients are affected by nausea, restlessness and a burning thirst, and within a short time, they expire.' - Aretaeus of Cappadocia (2nd Century AD)

How I love reading articles that describe unfortunate conditions with such familiarity and flair, putting the art into the science, the soft, romanticism into the hard, objectified physiology. :)