diabetestalk.net

Does Ketoacidosis Cause Weight Loss

Ketoacidosis During A Low-carbohydrate Diet

Ketoacidosis During A Low-carbohydrate Diet

To the Editor: It is believed that low-carbohydrate diets work best in reducing weight when producing ketosis.1 We report on a 51-year-old white woman who does not have diabetes but had ketoacidosis while consuming a “no-carbohydrate” diet. There was no family history of diabetes, and she was not currently taking any medications. While adhering to a regimen of carbohydrate restriction, she reached a stable weight of 59.1 kg, a decrease from 72.7 kg. After several months of stable weight, she was admitted to the hospital four times with vomiting but without abdominal pain. On each occasion, she reported no alcohol use. Her body-mass index (the weight in kilograms divided by the square of the height in meters) was 26.7 before the weight loss and 21.7 afterward. Laboratory evaluation showed anion-gap acidosis, ketonuria, and elevated plasma glucose concentrations on three of the four occasions (Table 1). She had normal concentrations of plasma lactate and glycosylated hemoglobin. Screening for drugs, including ethyl alcohol and ethylene glycol, was negative. Abdominal ultrasonography showed hepatic steatosis. On each occasion, the patient recovered after administration of intravenous fluids and insulin, was prescribed insulin injections on discharge, and gradually reduced the use of insulin and then discontinued it while remaining euglycemic for six months or more between episodes. Testing for antibodies against glutamic acid decarboxylase and antinuclear antibodies was negative. Values on lipid studies were as follows: serum triglycerides, 102 mg per deciliter; high-density lipoprotein (HDL) cholesterol, 50 mg per deciliter; and calculated low-density lipoprotein (LDL) cholesterol, 189 mg per deciliter. The patient strictly adhered to a low-carbohydrate diet for four Continue reading >>

Low-carb Diets & Ketoacidosis

Low-carb Diets & Ketoacidosis

Drastically switching up your diet always carries the risk of side effects -- which is why it's important to talk to a doctor first -- but low-carb diets shouldn't cause ketoacidosis. This life-threatening condition, which develops when the blood becomes acidic, is generally only a risk for people with undiagnosed or poorly controlled type-1 diabetes. Low-carb diets actually put you in ketosis, a very mild form of ketoacidosis that does not carry the same life-threatening risk. Video of the Day Low-Carb Diets and Your Metabolism Reducing your carb intake can whittle your waist, and more restrictive low-carb diets speed up weight loss by affecting how your body generates energy. Normally, your body turns to carbs as the primary source of energy for your cells, and several tissues -- like your liver and muscles -- store carbs in the form of glycogen for almost-immediate energy. However, on a low-carb diet you're not getting enough carbs to replenish those glycogen stores, so your body turns to fat. It burns fatty acids -- the fat molecules that help make up your fat tissue -- to create ketone bodies, an alternate source of fuel. Because you're creating more ketone bodies for energy, you're burning more fat -- and losing weight. Low-Carb Diets Cause Dietary Ketosis Diets low enough in carbs to switch your primary fuel source over to ketone bodies are called ketogenic diets, and those that restrict your carb intake to 20 to 25 grams daily are typically low-carb enough to put you into ketosis. In addition to burning fat, ketogenic diets help you lose weight by controlling your appetite. One study, published in the American Journal of Clinical Nutrition in 2008, found that men following a ketogenic diet ate less and reported feeling less hungry than dieters following a modera Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Will A State Of Ketosis Help Me Lose Weight?

Will A State Of Ketosis Help Me Lose Weight?

Many low-carbohydrate diets tout the benefits of being in a state of ketosis, which they claim results in weight loss. The idea is that by not eating enough carbohydrates to use as energy, your body will instead break down fat for energy. As a result, you will lose fat and weight. The idea of ketosis for weight loss, however, does not work as well in reality and comes with many health risks. Talk to your doctor before going on a diet that promotes ketosis. Video of the Day The state of ketosis occurs when ketone bodies, which are actually three biochemicals -- acetone, acetoacetic acid and beta-hydroxybutyric acid -- build up in your bloodstream. Your body needs carbohydrates to fully break down fat, so a lack of carbohydrates in your diet leads to ketosis. It is normal for the body to produce small amounts of ketone bodies, but when placed in a state of starvation, the liver produces ketone bodies from fatty acids to nourish essential organs like the brain and heart. The excess acetone is excreted in the urine and producing the characteristic sweet breath often found in diabetics Weight Loss Through Appetite Suppression It is possible to lose weight in the state of ketosis, especially in the beginning. This state can reduce your feelings of hunger so you eat less, which is the result touted by low-carbohydrate diets. Ketosis might even make you nauseous, making you not want to eat. A May 2008 study in “The American Journal of Clinical Nutrition” points out, however, that not enough evidence backs up the idea that ketones suppress appetite. Ketosis also might cause weight loss in the beginning of a diet because of a loss of water weight. Ketosis causes your body to get rid of sodium and to release more urine. This can result in losing about 100 to 150 calories a day Continue reading >>

How Ketosis Helps You Lose Weight Through Suppressed Appetite

How Ketosis Helps You Lose Weight Through Suppressed Appetite

One of the reasons The Bulletproof Diet with Bulletproof Coffee works so well for people looking to lose weight is that Bulletproof Intermittent Fasting helps your body to more easily enter a state called cyclical ketosis, which is great for a whole bunch of reasons. Ketosis is a cornerstone of becoming Bulletproof; listen to these recent Bulletproof Radio episodes with ketosis experts Jimmy Moore and Dominic D’Agostino to get the scoop on how and why it works. It’s what happens when your body switches to burning fat instead of sugar for energy, and it only happens when you eat almost no carbohydrates, or when you hack it using certain kinds of oils. Many people first stumble upon the idea of ketosis while looking for a weight loss strategy. That can be a major part of it for so many people out there who have tried just about every other diet out there but haven’t seen the results they’d hoped for. But when people experience the mental clarity and focus that ketosis brings, the game changes! This post walks you through one of the most important yet underrated mechanisms that makes ketosis so effective for people who have tried everything else to lose weight and failed to keep it off: appetite suppression. Ketosis works for weight loss in the short term, but that’s not why it’s so amazing. Short term weight loss is easy (I’ve lost at least 200 pounds of short term weight…because it always roared back on with a vengeance so I could lose it again!) When you look at keeping your weight off forever, ketosis provides a level of appetite suppression that is actually liberating. Ketosis helps you literally stop thinking about food all the time. Why Calorie Counting Is So Ineffective One of the reasons old-fashioned, calorie-restricted diets tend to fail is becau Continue reading >>

Diabulimia: A Life-threatening Approach To Thinness

Diabulimia: A Life-threatening Approach To Thinness

By Kathryn E. Ackerman, MD, MPH and Tarin E. Jackson People living with type 1 diabetes mellitus (DM) are taught to be conscious of the foods they eat. They decide their dose of insulin shots based on how many carbs they eat. This focus on food can become obsessive. People who have type 1 DM and are fixated on their body image are at risk for eating disorders similar to anorexia nervosa and bulimia. “Diabulimia” [dye-a-byoo-LEE-mee-uh], an unofficial, non-medical term that combines “diabetes” and “bulimia,” describes the condition that results from omitting or reducing insulin doses to lose weight. Insulin is a hormone that the body needs to metabolize food, specifically sugar (glucose). People with type 1 DM do not make insulin. As a result, their cells cannot use glucose and will “starve” unless insulin is injected. When the body cannot use glucose for energy, it begins to break down fat. This causes acid byproducts called ketones [KEE-tones]. Glucose is lost in the urine and fat is burned, leading to rapid weight loss. However, if the ketones and blood sugar levels continue to increase, the person’s life will be in danger from extreme dehydration and acidosis, known as diabetic ketoacidosis [KEE-toh-ass-i-DOH-sis] (DKA). Diabulimics often try a dangerous balancing act. They purposely skip some insulin doses to lose weight, while trying to avoid DKA. They may lie about their blood sugar levels, skip A1c checks, and use other means to hide their high blood sugars. Diabulimics often feel weak, cannot concentrate, and become thirsty. But even if diabulimics don’t develop DKA or the symptoms of poor blood sugar control, over time they will be at high risk for diabetic complications. These complications include kidney damage, blindness, and heart diseas Continue reading >>

Getting To Know Ketones

Getting To Know Ketones

People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f Continue reading >>

Lose Weight By Achieving Optimal Ketosis

Lose Weight By Achieving Optimal Ketosis

Do you want to lose weight? Here’s number 16 of my 18 best tips. All of the published tips can be found on the How to Lose Weight page. Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungry, eating real food, eating only when hungry, measuring progress wisely, being persistent, avoiding fruit, beer and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals, using intermittent fasting and finally, exercising smart. This is number sixteen: 16. Get into optimal ketosis Warning: Not recommended for type 1 diabetics, see below. We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again. So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect. Video course Do you know exactly how to eat a low-carb and high fat diet (LCHF)? This is required for ketosis. If not the easiest way is watching this high quality 11-minute video course on how to eat LCHF, and the most important things to think a Continue reading >>

Hyperglycemia & Weight Loss

Hyperglycemia & Weight Loss

Hyperglycemia is a condition that occurs when blood glucose levels rise high above the normal count. This condition can be caused by many things but occurs because the body is not producing enough insulin to break down glucose. The result is a high release of glucose into the blood stream. Hyperglycemia can be mild or severe and should be treated as soon as detected for the best results. Video of the Day The symptoms of hyperglycemia, according to National Institute of Health, are hunger, nervousness, shakiness, sweats, dizziness, sleepiness, confusion, weakness, difficulty speaking clearly and anxiety. Hyperglycemia can also occur while you are sleeping, which causes nightmares, dampness of sheets and clothing, and confusion or irritability upon waking up. Weight Loss and Hyperglycemia Weight loss associated with hyperglycemia is due to a low level of insulin. Insulin allows the body to break down glycogen for energy. When insulin levels are too low, according to the University of Iowa Hospital's and Clinics database, the body begins to break down its own stored fat for energy. This causes rapid weight and fat loss. According to James Norman, M.D., FACS, FACE, and author for EndocrineWeb, frequent hunger occurs in patients with hyperglycemia due to their inability to use glucose for energy. Because glucose is released into the urine and bloodstream rather than used by the body for energy, rapid weight loss occurs. If hyperglycemia goes on untreated, warns researchers from the University of Iowa Hospitals and Clinics database, a condition known as ketoacidosis can occur. When the body breaks down fats, it sends ketones into the urine stream. Too many ketones in the urine can cause ketoacidosis, a dangerous condition that can cause frequent urination, excessive dehydrati Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Unexplained Weight Loss

Unexplained Weight Loss

Tweet Unexplained weight loss is the term used to describe a decrease in body weight that occurs unintentionally and can be a warning sign of diabetes. The amount you weigh is determined by a number of factors including age, your calorie intake and overall health. Once you reach middle adulthood, your weight should remain relatively stable from year to year. Losing or gaining a few pounds here and there is normal, but unexplained weight loss that is significant (10 lbs/4.5kg or more or over 5% of your body weight) or persistent may signal an underlying medical condition. Unexplained weight loss means weight loss that occurs without trying through dieting or exercising. What are the possible causes of unexplained weight loss? Unintentional or unexplained weight loss can be caused by a number of things, including depression, certain medication and diabetes. Potential causes of unexplained weight loss include: Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need lon Continue reading >>

Ketoacidosis Versus Ketosis

Ketoacidosis Versus Ketosis

Some medical professionals confuse ketoacidosis, an extremely abnormal form of ketosis, with the normal benign ketosis associated with ketogenic diets and fasting states in the body. They will then tell you that ketosis is dangerous. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com Ketosis is NOT Ketoacidosis The difference between the two conditions is a matter of volume and flow rate*: Benign nutritional ketosis is a controlled, insulin regulated process which results in a mild release of fatty acids and ketone body production in response to either a fast from food, or a reduction in carbohydrate intake. Ketoacidosis is driven by a lack of insulin in the body. Without insulin, blood sugar rises to high levels and stored fat streams from fat cells. This excess amount of fat metabolism results in the production of abnormal quantities of ketones. The combination of high blood sugar and high ketone levels can upset the normal acid/base balance in the blood and become dangerous. In order to reach a state of ketoacidosis, insulin levels must be so low that the regulation of blood sugar and fatty acid flow is impaired. *See this reference paper. Here's a table of the actual numbers to show the differences in magnitude: Body Condition Quantity of Ketones Being Produced After a meal: 0.1 mmol/L Overnight Fast: 0.3 mmol/L Ketogenic Diet (Nutritional ketosis): 1-8 mmol/L >20 Days Fasting: 10 mmol/L Uncontrolled Diabetes (Ketoacidosis): >20 mmol/L Here's a more detailed explanation: Fact 1: Every human body maintains the blood and cellular fluids within a very narrow range between being too acidic (low pH) and too basic (high pH). If the blood pH gets out of the normal range, either too low or too high, big problems happen. Fact 2: The Continue reading >>

Why Do People With Diabetes Lose Weight?

Why Do People With Diabetes Lose Weight?

Diabetes mellitus is a metabolic disorder where the body does not use energy properly. One of the symptoms of diabetes is sudden and unexplained weight loss. Excessive hunger and thirst are two other symptoms, and patients with untreated diabetes may find themselves losing weight even as they are eating and drinking more than usual. There are several reasons why people with diabetes lose weight, but to better understand why weight loss occurs, you need to explore how diabetes affects the body. Video of the Day Under normal circumstances, your body converts food into sugar during the digestive process. The sugar enters your bloodstream and the pancreas, a small organ behind the liver, release a chemical known as insulin. Insulin tells all the cells in the body to take sugar from the blood and convert it to energy, which the cells use as fuel. Types of Diabetes There are two types of diabetes mellitus -- type 1 and type 2. With type 1 diabetes, the body either does not make insulin, or it does not make enough, and the cells never get the chemical signal to absorb sugar from the blood. With type 2 diabetes, the body makes insulin but the cells do not respond to the chemical signals, or they respond incorrectly. In both instances, the sugar stays in the bloodstream, where the body is unable to use it for energy. When the cells are unable to use sugar for energy, they send a signal to the brain that they need more fuel. The brain then triggers the hunger response to encourage you to eat, hence the excessive hunger that often occurs with diabetes. However, the more you eat, the more sugar ends up in your bloodstream instead of in the cells, where it belongs. You kidneys then have to work overtime to clear the sugar from your blood through the urine. Your kidneys have to use a Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Tweet Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. DKA is most commonly associated with type 1 diabetes, however, people with type 2 diabetes that produce very little of their own insulin may also be affected. Ketoacidosis is a serious short term complication which can result in coma or even death if it is not treated quickly. Read about Diabetes and Ketones What is diabetic ketoacidosis? DKA occurs when the body has insufficient insulin to allow enough glucose to enter cells, and so the body switches to burning fatty acids and producing acidic ketone bodies. A high level of ketone bodies in the blood can cause particularly severe illness. Symptoms of DKA Diabetic ketoacidosis may itself be the symptom of undiagnosed type 1 diabetes. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration An unusual smell on the breath –sometimes compared to the smell of pear drops Deep laboured breathing (called kussmaul breathing) or hyperventilation Rapid heartbeat Confusion and disorientation Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period if blood glucose levels become and remain too high (hyperglycemia). Causes and risk factors for diabetic ketoacidosis As noted above, DKA is caused by the body having too little insulin to allow cells to take in glucose for energy. This may happen for a number of reasons including: Having blood glucose levels consistently over 15 mmol/l Missing insulin injections If a fault has developed in your insulin pen or insulin pump As a result of illness or infections High or prolonged levels of stress Excessive alcohol consumption DKA may also occur prior to a diagnosis of type 1 diabetes. Ketoacidosis can occasional Continue reading >>

How To Use (and Not To Use) Exogenous Ketones For Weight Loss

How To Use (and Not To Use) Exogenous Ketones For Weight Loss

“How do I use ketones to help me lose weight?” Great question. It’s worth the few minutes to understand how exogenous ketones can help people lose weight on a ketogenic diet, and not just jump to the conclusion that ketones = weight loss. Breaking Down Ketone Weight Loss Misconceptions The most common misconception (perhaps due to excessive marketing claims) is that taking ketone supplements will induce immediate weight loss. The purpose of this article is to explain how to use ketones as a piece of the puzzle in your weight loss lifestyle. Remember exogenous ketones are supplements. Very effective at what they do, but none the less, should be supplementary to a low carb/ketogenic style of eating that is geared towards weight loss (if weight loss is the goal). Ketones don’t cause weight loss, they help cause ketosis. Ketosis is a metabolic state where your body is using fatty acids for its primary source of energy. Just because you are using fat does not necessarily mean you are going to be losing weight or have a decrease in body fat percentage over an extended period of time. I have been in deep nutritional ketosis (>3.0mmol/dL) and had an increase in body fat percentage. I’ve also been in deep nutritional ketosis and had a decrease in body fat percentage. It all depends on how much fat and protein you are eating, in addition to being below a carb threshold that will induce ketosis. Please don’t take this to mean starve yourself. It just means that the average male American has over 40,000 calories in stored body fat and can, therefore, afford to eat a lower calorie ketogenic diet, and still survive (and thrive!). Take home message: Exogenous ketones are a tool to get you into ketosis or to boost your energy levels while already in ketosis. If your motive Continue reading >>

More in ketosis