I have just read
What Does The Death of Robert Atkins Tell Us About the Atkins Diet?
We know that Atkins slipped on ice outside his office. He hit the pavement with his head and got an intracranial hemorrage
“[A] hospital note on admission showed him [Atkins] weighing 195 pounds [88.5 kg]. A substantial weight gain of 63 pounds [28.6 kg] occurred in the 9 days after his admission due to the accumulation of fluid volume and swelling which is not uncommon in the critically ill.”
This means that Atkins increased 32 % in weight during 9 days or 3.2 kg per day despite he could not eat, he was in coma.
How can you increase that much in weight, 3.2 kg per day when not eating?
There is just one explanation.
He had a lot of glucose infused intravenously.
His normal P-glucose should have been between 3 and 6 mmol/L (54-108 mg/dL). That means he had between 1.9 and 3.8 grams of glucose in his total blood volume of 7.1 L.
By infusing 5 % glucose he had 50 grams of glucose per liter IV fluid. To maintain his metabolism of 2 500 kcal per 24 h they would have to shuffle in 625 grams of glucose per 24 hours. That means they would have to infuse 12.5 L of 5 % glucose.
Surely, they didn’t.
But they must have given him at least 3-4 liters of 5 % glucose per day. That is 150-200 g glucose per day, or more than 50 times his normal glucose content in his blood.
His blood glucose must have skyrocketed as he didn’t have the normal enteral defence mechanisms against high blood glucose as he got the glucose parenterally..
His insulin must have worked overtime to distribute and get rid of that enormous amount of glucose. Forcing the glucose into every cell, excreting glucose by all means, burning and fermenting glucose.
We should all remember that one glucose molecule is always surrounded by 190 water molecules that also needs ½ a sodium ion to maintain salt concentration in the extracellular fluid
Consequently, that 28.6 kg weight increase must have consisted of at least 1.4 kg glucose surrounded by 27.0 kg water and 0.2 kg salt
If you have more than 50 mmol/L (>900 mg/dL) in your blood you die very soon in an acute glucose poisoning.
Why is such a high concentration of glucose in the blood lethal?
- High level of glucose means a high rate of glycation of proteins. Hemoglobin is glycated and converted into HbA1c. An HbA1c molecule is sterically hindrerd by a sugar molecule in the binding site to bind and transport oxygen in the blood. The glycating sugar is sitting and blocking the oxygen binding site on the haemoglobin molecule.
As the HbA1c percent usually is about the same as the glucose level in mmol/L then the HbA1c increases to more than 50% which means lack of oxygen for the brain and the rest of the body.
- Many other enzymes and cellular signalling molecules will be glycated in the same way as haemoglobin which decreases the cells viability or even kills cells.
- All cells and the extracellular fluids are full of glucose molecules surrounded by a cloud of water molecules.
- The patient dies.
So it seems it was his colleagues in the health care system that by ignorance(?) killed Atkins.