  Neoplasms are highly dependent on glucose as their substrate for energy
production and are generally not able to catabolize other fuel sources such as
ketones and fatty acids. Thus, removing access to glucose has the potential to
starve cancer cells and induce apoptosis. Unfortunately, other body tissues are
also dependent on glucose for energy under normal conditions. However, in human
starvation (or in the setting of diet-induced ketogenesis), the body
"keto-adapts" and glucose requirements of most tissues drop to almost nil.
Exceptions include the central nervous system (CNS) and various other tissues
which have a small but obligatory requirement of glucose. Our hypothesized
treatment takes keto-adaptation as a prerequisite. We then propose the
induction of severe hypoglycemia by depressing gluconeogenesis while
administering glucose to the brain. Although severe hypoglycemia normally
produces adverse effects such as seizure and coma, it is relatively safe
following ketoadaptation. We hypothesize that our therapeutic hypoglycemia
treatment has potential to rapidly induce tumor cell necrosis.
