diabetestalk.net

Does Ketosis Cause Ketoacidosis

Fasting Ketosis And Alcoholic Ketoacidosis

Fasting Ketosis And Alcoholic Ketoacidosis

INTRODUCTION Ketoacidosis is the term used for metabolic acidoses associated with an accumulation of ketone bodies. The most common cause of ketoacidosis is diabetic ketoacidosis. Two other causes are fasting ketosis and alcoholic ketoacidosis. Fasting ketosis and alcoholic ketoacidosis will be reviewed here. Issues related to diabetic ketoacidosis are discussed in detail elsewhere. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment".) PHYSIOLOGY OF KETONE BODIES There are three major ketone bodies, with the interrelationships shown in the figure (figure 1): Acetoacetic acid is the only true ketoacid. The more dominant acid in patients with ketoacidosis is beta-hydroxybutyric acid, which results from the reduction of acetoacetic acid by NADH. Beta-hydroxybutyric acid is a hydroxyacid, not a true ketoacid. Continue reading >>

What Is Ketoacidosis? A Comprehensive Guide

What Is Ketoacidosis? A Comprehensive Guide

Ketoacidosis is lethal. It is responsible for over 100,000 hospital admissions per year in the US with a mortality rate of around 5%. In other words, ketoacidosis is to blame for about 5,000 deaths per year. The cause? A deadly combination of uncontrolled hyperglycemia, metabolic acidosis, and increased ketone body levels in the blood (more on this deadly combination later). Luckily, this lethal triad rarely affects individuals who don’t have diabetes. However, the majority (80%) of cases of diabetic ketoacidosis occur in people with a known history of diabetes mellitus (any form of diabetes). Ketoacidosis vs. Diabetic Ketoacidosis — What’s The Difference? At this point, you may have noticed that I used ketoacidosis and diabetic ketoacidosis interchangeably. This is because it is difficult for the body to get into a state of ketoacidosis without the blood sugar control issues that are common in people with diabetes. Hence, the term diabetic ketoacidosis. (However, there is another form of ketoacidosis called alcoholic ketoacidosis. This occurs in alcoholics who had a recent alcohol binge during a period of time when they didn’t eat enough.) Ketoacidosis tends to occur the most in people who have type 1 diabetes. Somewhere between 5 and 8 of every 1,000 people with type 1 diabetes develops diabetic ketoacidosis each year. Type 2 diabetics also run the risk of ketoacidosis under stressful situations, but it is much rarer because type 2 diabetics have some remaining insulin production (type 1 diabetics do not). If you are not part of the 422 million people worldwide that have diabetes, your risk of getting ketoacidosis is negligible. You would have to put yourself through years of stress, inactivity, and unhealthy eating habits before you experience ketoacidosis. ( Continue reading >>

Ketosis Explained – For Weight Loss, Health Or Performance

Ketosis Explained – For Weight Loss, Health Or Performance

Get Started Ketosis is a natural state for the body, when it is almost completely fueled by fat. This is normal during fasting, or when on a strict low-carb diet. Ketosis has many potential benefits, but there are also side effects. In type 1 diabetes and certain other rare situations excessive ketosis can even become dangerous. On this page you can learn all about how to harness the benefits of ketosis, while avoiding any problems. It all starts with understanding what ketosis is. Choose a section, or keep reading below for all of them. Ketosis ExplainedKetosis Explained BenefitsBenefits How to Get Into KetosisHow to Get Into Ketosis Ketosis ExplainedSymptoms & How to Know You’re In Ketosis Side Effects, Fears & Potential DangersSide Effects, Fears & Potential Dangers How to Reach Optimal KetosisHow to Reach Optimal Ketosis ketones Ketosis Explained The “keto” in the word ketosis comes from the fact that it makes the body produce small fuel molecules called “ketones”.1 This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply. Ketones are produced if you eat very few carbs (that are broken down into blood sugar) and only moderate amounts of protein (excess protein can be converted to blood sugar). Ketones are produced in the liver, from fat. They are then consumed as fuel in the body, including by the brain. This is important as the brain is a hungry organ that consumes lots of energy every day,2 and it can’t run on fat directly. It can only run on glucose… or ketones. Maximizing fat burning On a ketogenic diet your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is o Continue reading >>

Why Dka & Nutritional Ketosis Are Not The Same

Why Dka & Nutritional Ketosis Are Not The Same

There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstandings lie in the areas of: ketones that are produced in low-carb diets of generally less than 50 grams of carbs per day, which is low enough to put a person in a state of “nutritional ketosis” ketones that are produced when a diabetic is in a state of “diabetic ketoacidosis” (DKA) and lastly, there are “starvation ketones” and “illness-induced ketones” The fact is they are very different. DKA is a dangerous state of ketosis that can easily land a diabetic in the hospital and is life-threatening. Meanwhile, “nutritional ketosis” is the result of a nutritional approach that both non-diabetics and diabetics can safely achieve through low-carb nutrition. Diabetic Ketoacidosis vs. Nutritional Ketosis Ryan Attar (soon to be Ryan Attar, ND) helps explain the science and actual human physiology behind these different types of ketone production. Ryan is currently studying to become a Doctor of Naturopathic Medicine in Connecticut and also pursuing a Masters Degree in Human Nutrition. He has interned under the supervision of the very well-known diabetes doc, Dr. Bernstein. Ryan explains: Diabetic Ketoacidosis: “Diabetic Ketoacidosis (DKA), is a very dangerous state where an individual with uncontrolled diabetes is effectively starving due to lack of insulin. Insulin brings glucose into our cells and without it the body switches to ketones. Our brain can function off either glucose or fat and ketones. Ketones are a breakdown of fat and amino acids that can travel through the blood to various tissues to be utilized for fuel.” “In normal individuals, or those with well controlled diabetes, insulin acts to cancel the feedback loop and slow and sto Continue reading >>

The Difference Between Ketosis And Ketoacidosis

The Difference Between Ketosis And Ketoacidosis

When you hear these two terms it’s easy to see how they can be confused. The confusion also stems from the fact that the two are both metabolic processes involving the breakdown of fats in the body (plus they look and sound like similar words). The truth is ketosis and ketoacidosis are two completely different things. Ketosis and the Ketogenic Diet Ketosis is a normal metabolic process in which the body has a high fat-burning rate. It is a healthy and natural state your body enters when your body is running on fat rather than glucose1. The state of ketosis occurs when ketone levels are raised in the blood due to the conversion of fats into fatty acids and ketones. This happens when the body runs out of carbohydrates – usually because a person hasn’t eaten in a while, for example during fasts, or they eat a very low-carbohydrate diet – leaving little sugar to convert into glycogen. Without glycogen, the body breaks down fat cells for energy. A low-carb, high fat diet, also known as a ketogenic diet, is necessary to enter and stay in ketosis long-term. When you eat a low-carbohydrate diet, your body enters the metabolic state of ketosis within 2 days but it can vary from person to person. There are many benefits2 to being in longer-term ketosis including: lowered triglycerides levels no spikes in blood glucose levels greater mental clarity lowered blood pressure and cholesterol reduced food and sugar cravings weight loss Ketoacidosis – The Body in a State of Toxicity Ketoacidosis is a metabolic state of toxicity. It occurs when the body fails to regulate ketone production resulting in severe accumulation of keto acids which cause the pH of the blood to decrease substantially making the blood more acidic. The most common causes for ketoacidosis are Type 1 Diabete Continue reading >>

The Ketogenic Diet And Type 1 Diabetes

The Ketogenic Diet And Type 1 Diabetes

What is type 1 diabetes? How is it different than type 2? Type 2 diabetes is a condition where the body becomes resistant to insulin, forcing the pancreas to produce ever more insulin, and leading to a downward spiral of metabolic illness. It’s also called “Adult Onset Diabetes”, because the vast majority of people who develop it do so in adulthood, after years of eating a high-carb diet. Type 1 diabetes, also known as “Juvenile Diabetes”, is a disorder where the body’s immune system attacks the cells of the pancreas responsible for producing insulin. Only the pancreas can produce insulin, and insulin is the hormone primarily responsible for shuttling molecules out of the blood and into cells for energy or storage. That means, if the pancreas isn’t producing insulin, a person will starve to death from the inside. Their cells, literally, cannot get any food. They can eat and eat and eat, but there’s no mechanism to transport that food energy into the cells. That’s why they need regular insulin shots. On a regular-carb diet, those insulin shots might be several times per day. On a high-carb diet, those shots will be even more frequent. Type 1 diabetics must keep injecting themselves with insulin in order to deal with all the glucose in their blood stream. They have to keep insulin levels high, if they eat high carbs, because they have a high level of glucose to deal with. Being ketogenic means insulin levels don’t have to be high, because there isn’t a high level of glucose that needs to be shuttled around. And, because there isn’t a big requirement for insulin, the type 1 diabetic can reduce the amount of insulin needed on a daily basis (many reduce this requirement by 80%). The important thing to remember is that someone suffering from type 1 dia Continue reading >>

Ketosis Vs. Ketoacidosis: Understanding The Differences

Ketosis Vs. Ketoacidosis: Understanding The Differences

Introduction to Ketosis vs Ketoacidosis Historically, ketosis has been one of the most vaguely defined and poorly understood concepts of the last century. There are different scenarios in which are body can be in a state of ketosis (including ketoacidosis). The most basic definition of ketosis is a general increase in blood levels of ketone bodies to 0.5 mmol or above. However, the reasons for the development of ketosis, the resultant levels of blood ketones, and the associated outcomes (health versus possible death) differ drastically between different situations of ketosis. Failure to understand the differences between various incidents of ketosis has led to the common misconceptions we have today that ultimately has made educating the masses on the ketogenic diet difficult. The single most important take home from this article should be that diabetic ketoacidosis is not the same as the ketosis experienced from a ketogenic diet. Diabetic Ketoacidosis Whenever I speak about ketogenic dieting, almost inevitably I am asked the question: “But shouldn’t you be worried about going into a state of ketoacidosis?” Ketoacidosis occurs when the formation ketone bodies are uncontrolled (15-25 mmol) and acidity in the blood increases (1). It is important to understand that our body regulates blood acid concentrations tightly. We typically measure blood acidity vs. alkalinity using the pH scale. If your blood’s pH is less than 7 it is acidic, and if greater it is basic, or alkaline. Our blood is usually slightly alkaline with a pH ranging from 7.35 to 7.45. Any deviation up or down from the norm by even the smallest amount can prove fatal! The most common form of ketoacidosis to occur is known as diabetic ketoacidosis. This usually occurs in type I diabetics but can also oc Continue reading >>

Ketosis

Ketosis

Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>

Too Many Ketones Can Cause Ketoacidosis, Which Is Very Dangerous. Can Keto//os Create Ketoacidosis?

Too Many Ketones Can Cause Ketoacidosis, Which Is Very Dangerous. Can Keto//os Create Ketoacidosis?

Ketosis is NOT diabetic ketoacidosis, which is a serious complication of uncontrolled diabetes that occurs when your body produces high levels of blood acids called ketones in conjunction with high levels of glucose. You can consider comparing therapeutic ketosis to ketoacidosis to be like comparing a fireplace to a house fire. Fire is a great and useful thing when controlled and in the proper situations, but it also has the potential to become very dangerous if not used properly. Ketones are therapeutic and beneficial when in a certain blood level, but are very dangerous at extremely high levels. In therapeutic ketosis, total blood ketones are in the 0.5-5mM range while in ketoacidosis, blood ketones are typically >20mM. This is a huge difference. There is no reason to be scared of elevating blood ketones to the levels seen in therapeutic ketosis, but rather this level of ketosis is associated with many health benefits (improvements in metabolic health, weight loss, neuroprotection, etc). Until very recently, the only way you could receive the many benefits of ketones would be consuming a calorie restricted or carbohydrate restricted ketogenic diet. The benefit of exogenous ketones with KETO//OS the first of its kind that is exclusive worldwide with the Pruvit product is that since you are consuming (at least in the part of the BHB-salt), pure ketones, making it easier to elevate blood ketones to therapeutic levels. This also means, though, theoretically, you can elevate your blood ketones to any level depending on how much of the product is consumed. So, is it possible to elevate your blood ketones to a dangerous level with this product? Yes, technically it could be done; however, it would require consuming much more than the recommended use in one sitting. On average Continue reading >>

Ketones: Clearing Up The Confusion

Ketones: Clearing Up The Confusion

Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>

Does The Ketogenic Diet Work For Type 2 Diabetes?

Does The Ketogenic Diet Work For Type 2 Diabetes?

You’ve probably seen dozens of headlines about the ketogenic diet by now, which has made its way into popular culture largely by celebrities and supermodels giving the long-standing fad diet a repeated stamp of approval. Is this the diet to follow if you have diabetes? Studies suggest the answer isn’t so simple. Some science shows its meal plan may be helpful, while other research, like one study published in September 2016 in Nutrients, highlights the importance of whole grains in the diets of people with diabetes — a restricted food category in the ketogenic diet. While the keto diet can offer many potential benefits for diabetes management, following it requires pretty serious commitment. So take a beat before you take the plunge — and consider these questions that can help you and your medical team determine if it’s right for you: How Does the Ketogenic Diet Work Exactly? There’s a good reason the ketogenic diet is also referred to as a low-carb, high-fat diet. Indeed, following the ketogenic diet means reducing carbohydrate intake to typically less than 50 grams (g) of carbohydrates per day, while increasing fat and protein intake, according to a review published in August 2013 in the European Journal of Clinical Nutrition. To put that into perspective, an individual on an average, non-restricted diet can easily eat more carbohydrates than that in one typical meal — for instance, a turkey, cheese, and veggie sandwich on whole-grain bread with a small, 1 ounce (oz) bag of classic potato chips would come in at around 51 g of carbs. These dietary changes drive down insulin levels, eventually leading your body into a state of ketosis, during which it is burning fat rather than carbohydrates. What Are Some of the Potential Benefits of a Ketogenic Diet for 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 >>

Ketosis – What Is That All About?

Ketosis – What Is That All About?

What’s it all about? Is it good for you? Is it bad for you? What’s it like? How do I ‘do’ ketosis? How do I know I’m in ketosis? The questions everyone who’s Banting wants the answers to. Ketosis, in chef speak, is quite simply a state your body enters once it has been deprived of glucose. Your body switches to burning fat for energy (stored fat or fat that you have eaten) instead of glucose. A side-effect of that process is the release of ketone bodies into the blood stream. When you’re starved of glucose, your body has no choice but to burn fat for fuel, so it needs little explanation as to why ketosis works at melting fat like a blow heater on an ice sculpture. Ketosis comes with some added extras, namely a commonly noted sense of euphoria or lucidity and increased energy levels. A downside includes toothbrush-proof halitosis, which stems from the secretion of ammonia through the lungs as a side effect of burning all that fat. Some people on low-carb diets have reported kidney stones, gallstones and a number of other ailments. Scientific research on both sides of this debate is being done all the time, but in our experience from talking to the members of our community and tracking their data, it is generally a case of what was done before they started Banting and not Banting itself. But, this post isn’t here to debate that, it serves as a ‘how to’ and not as a ‘you should’. Eat more buttery or creamy sauce on your steak and eat less steak. Your body can convert protein into glucose so too much meat will hinder your progress. What doIdo? Theoretically it is very easy. Avoid anything with high carbs in it. If you’re not sure what those might be, consult the Real Meal Revolution ‘Red List’. Even dipping your toe into the red list will ruin Continue reading >>

Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood

Metabolic Effects Of The Very-low-carbohydrate Diets: Misunderstood "villains" Of Human Metabolism

Go to: The Ketone Bodies are an Important Fuel The hormonal changes associated with a low carbohydrate diet include a reduction in the circulating levels of insulin along with increased levels of glucagon. This activates phosphoenolpyruvate carboxykinase, fructose 1,6-biphosphatase, and glucose 6-phosphatase and also inhibits pyruvate kinase, 6-phosphofructo-1-kinase, and glucokinase. These changes indeed favor gluconeogenesis. However, the body limits glucose utilization to reduce the need for gluconeogenesis. In the liver in the well-fed state, acetyl CoA formed during the β-oxidation of fatty acids is oxidized to CO2 and H2O in the citric acid cycle. However, when the rate of mobilization of fatty acids from adipose tissue is accelerated, as, for example, during very low carbohydrate intake, the liver converts acetyl CoA into ketone bodies: Acetoacetate and 3-hydroxybutyrate. The liver cannot utilize ketone bodies because it lacks the mitochondrial enzyme succinyl CoA:3-ketoacid CoA transferase required for activation of acetoacetate to acetoacetyl CoA [3]. Therefore, ketone bodies flow from the liver to extra-hepatic tissues (e.g., brain) for use as a fuel; this spares glucose metabolism via a mechanism similar to the sparing of glucose by oxidation of fatty acids as an alternative fuel. Indeed, the use of ketone bodies replaces most of the glucose required by the brain. Not all amino acid carbon will yield glucose; on average, 1.6 g of amino acids is required to synthesize 1 g of glucose [4]. Thus, to keep the brain supplied with glucose at rate of 110 to 120 g/day, the breakdown of 160 to 200 g of protein (close to 1 kg of muscle tissue) would be required. This is clearly undesirable, and the body limits glucose utilization to reduce the need for gluconeogenesis Continue reading >>

The Paleo Guide To Ketosis

The Paleo Guide To Ketosis

Ketosis is a word that gets tossed around a lot within the Paleo community – to some, it’s a magical weight-loss formula, to others, it’s a way of life, and to others it’s just asking for adrenal fatigue. But understanding what ketosis really is (not just what it does), and the physical causes and consequences of a fat-fueled metabolism can help you make an informed decision about the best diet for your particular lifestyle, ketogenic or not. Ketosis is essentially a metabolic state in which the body primarily relies on fat for energy. Biologically, the human body is a very adaptable machine that can run on a variety of different fuels, but on a carb-heavy Western diet, the primary source of energy is glucose. If glucose is available, the body will use it first, since it’s the quickest to metabolize. So on the standard American diet, your metabolism will be primarily geared towards burning carbohydrates (glucose) for fuel. In ketosis, it’s just the opposite: the body primarily relies on ketones, rather than glucose. To understand how this works, it’s important to understand that some organs in the body (especially the brain) require a base amount of glucose to keep functioning. If your brain doesn’t get any glucose, you’ll die. But this doesn’t necessarily mean that you need glucose in the diet – your body is perfectly capable of meeting its glucose needs during an extended fast, a period of famine, or a long stretch of very minimal carbohydrate intake. There are two different ways to make this happen. First, you could break down the protein in your muscles and use that as fuel for your brain and liver. This isn’t ideal from an evolutionary standpoint though – when you’re experiencing a period of food shortage, you need to be strong and fast, Continue reading >>

More in ketosis