What Are Ketones?
What are ketones and what causes them? Ketones are the result of the body burning fat for energy or fuel. For a person with diabetes, ketones are often the result of prolonged high blood sugar and insulin deficiency. Without the right amount of insulin, glucose starts to build up in the blood stream and doesn't enter the cells. The cells burn fat instead of glucose, and ketones form in the blood and spill into the urine. Some causes of high blood sugar are: Missing an insulin dose or skipping some oral medications. A disconnected or blocked insulin pump tube. Being sick with the flu. High levels of stress. Eating more carbohydrates than your medication covers. What are the signs that I should test for ketones? Symptoms of high blood sugar include frequent urination, frequent thirst, blurry vision, dry mouth, vomiting, and fatigue. There are several scenarios that should prompt a test for ketones. If your blood sugar is over 240 mg/dl for two tests in a row. When you are ill. When your blood sugar is over 240 mg/dl and you are planning on exercising. If you are pregnant, you should test for ketones each morning before breakfast and whenever blood sugars are elevated. How do I test for ketones? There are two ways to test for ketones - by testing your urine or your blood. Ketones appear first in the blood stream and are later present in the urine, so testing your blood for ketones is the best way to check for an early problem. To check urine for ketones, you must collect a urine sample or dip a ketone test strip into a fresh stream of urine. After waiting for the time suggested by the ketone strip manufacturer, you compare the color strip to the chart on the bottle. The darker the color, the higher the amount of ketones in the urine. At this time, there are just a few mete Continue reading >>
What Are Ketones?
With the gradual resurgence of low-carb diets in recent years, the word “ketones” is thrown around a lot. But many people aren’t really aware of the details. What are ketones, really? And what do they do in the body? There can be a lot of misinformation regarding the answers to these questions, so read on for a full overview of ketones and their role in a ketogenic diet. Ketones, also known as “ketone bodies,” are byproducts of the body breaking down fat for energy that occurs when carbohydrate intake is low. Here’s how it works: When there isn’t a sufficient level of available glucose — which is what the body uses for its main source of fuel — and glycogen levels are depleted, blood sugar and insulin are lowered and the body looks for an alternative source of fuel: in this case, fat. This process can happen when a person fasting, after prolonged exercise, during starvation, or when eating a low-carb, ketogenic diet. And when the body begins breaking down fats for energy like this, a process known as beta-oxidation, ketones are formed for use as fuel for the body and brain. This is known as ketosis. People following a ketogenic diet specifically reduce their carbohydrate intake for this reason: to create ketones for energy. Many people use the benefits of ketosis — less reliance on carbs and more burning of fat — to possibly help lower blood pressure, reduce cravings, improve cholesterol, increase weight loss, improve energy, and more. TYPES OF KETONE BODIES So, what else about ketones do we need to know? To start, there are technically three types of ketone bodies: Acetoacetate (AcAc) Beta-hydroxybutyric acid (BHB) Acetone Both acetoacetate and beta-hydroxybutyrate are responsible for transporting energy from the liver to other tissues in the body Continue reading >>
Diabetic Ketoacidosis- Enzyme For Ketones Formation?
Case details A 54- year-old man with Type 1 diabetes is referred to an ophthalmologist for evaluation of developing cataract. Blood chemistry results are shown below- Fasting blood glucose 198 mg/dl Hemoglobin A 15 gm/dl Hemoglobin A 1c 10% of total Hb Urine ketones Positive Urine glucose Positive Which of the following enzymes is most strongly associated with ketones formation in this patient? A) Pyruvate dehydrogenase complex B) Thioesterase C) Thiophorase D) Thiokinase E) Thiolase. The correct answer is- E- Thiolase. Out of the given options thiolase is the only enzyme involved in the ketogenesis. The process of ketogenesis starts from the action of thiolase. In fact, the actual specific enzyme for ketogenesis is HMG Co A Synthase (mitochondrial isoform) which is not mentioned in the given options. Ketone bodies Acetoacetate, D (-3) -hydroxybutyrate (Beta hydroxy butyrate), and acetone are often referred to as ketone bodies (figure-1). Figure-1- Acetoacetate is the primary ketone body, the other ketone bodies are derived from it. The term “ketones” is actually a misnomer because beta-hydroxybutyrate is not a ketone and there are ketones in blood that are not ketone bodies, e.g., pyruvate, fructose. Ketogenesis takes place in liver using Acetyl co A as a substrate or a precursor molecule. Enzymes responsible for ketone body formation are associated mainly with the mitochondria. Steps of synthesis Acetoacetate (First ketone body) is formed from acetyl CoA in three steps (Figure-2). 1) Two molecules of acetyl CoA condense to form Acetoacetyl CoA. This reaction, which is catalyzed by thiolase, is the reverse of the thiolysis step in the oxidation of fatty acids. 2) Acetoacetyl CoA then reacts with acetyl CoA and water to give 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) Continue reading >>
Excess ketones are dangerous for someone with diabetes... Low insulin, combined with relatively normal glucagon and epinephrine levels, causes fat to be released from fat cells, which then turns into ketones. Excess formation of ketones is dangerous and is a medical emergency In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketones can develop. What are ketones and why do I need to know about them? Ketones and ketoacids are alternative fuels for the body that are made when glucose is in short supply. They are made in the liver from the breakdown of fats. Ketones are formed when there is not enough sugar or glucose to supply the body’s fuel needs. This occurs overnight, and during dieting or fasting. During these periods, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin, and relatively normal glucagon and epinephrine levels causes fat to be released from the fat cells. The fats travel through the blood circulation to reach the liver where they are processed into ketone units. The ketone units then circulate back into the blood stream and are picked up by the muscle and other tissues to fuel your body’s metabolism. In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketone Continue reading >>
Ketone Bodies: Formation And Utilisation | Living Organisms | Biology
ADVERTISEMENTS: In this article we will discuss about:- 1. Formation of Ketone Bodies 2. Conditions Leading to Ketosis 3. Source 4. Utilisation 5. Interrelation with Carbohydrate Metabolism 6. Ratio 7. Relation of Ketosis with Blood and Urine Reaction 8. Role of Endocrine. Formation of Ketone Bodies (Ketogenesis): It has been observed that acetyl CoA produced during fatty acid oxidation condense with oxalo-acetic acid for oxidation in the TCA cycle. The oxalo-acetic acid formation is depressed when glucose supply is restricted so that in this condition acetyl CoA cannot be properly metabolized through citric acid cycle. Thus acetyl CoA condenses to form aceto-acetyl CoA which in the liver produces aceto-acetic acid. The aceto-acetic acid is reduced to form β-hydroxybutyric acid which after decarboxylation forms acetones. Acetoacetic acid, acetone and β-hydroxybutyric acid are called ketone bodies. The process of formation of ketone bodies is called ketogenesis. Normally the ketone bodies are utilized without being accumulated in the body, but they may be abnormally accumulated in body fluids known as ketosis and excreted through the urine called ketonuria (or acetonuria). Its accumulation in the blood is called ketonemia. Site of Formation of Ketone Bodies: Liver is perhaps the only site where ketone bodies are normally formed since concentration of ketone bodies have been found to be higher in the hepatic vein than in other veins. Antiketogenic Substances: These are substances which prevent the formation of ketone bodies. They include the following: (1) All carbohydrates, (2) 60% of proteins (antiketogenic amino acids) from which sugar may be formed and (3) 10% of fats (the glycerol part) Conditions Leading to Ketosis: The following conditions produce ketosis: (a) Di Continue reading >>
Ketone Body Metabolism
Sort Scenario: Blood glucose levels decline due to starvation... Require: Tactic changes: Hormonal changes: Metabolic changes: Require: maintenance of blood glucose levels Tactic changes: - peripheral tissue glucose utilization + hepatic glucose production (gluconeogenesis) Hormonal changes: - insulin + glucagon + epinephrine and lipolytic hormones Metabolic changes: + lipolysis and ketogenesis for alternative fuels + hepatic beta oxidation to drive gluconeogenesis What substrates are required for gluconeogenesis to occur and how are these substrates replenished? Gluconeogenesis requires (1) C4 carbon sources and (2) high energy. -Carbon sources are replenished by glucogenic AA breakdown -Energy is replenished via beta oxidation of FA and oxidative phosphorylation -Acetyl CoA (produced by beta oxidation) promotes gluconeogenesis by activating pyruvate carboxylase (hormone required for gluconeogenesis) Continue reading >>
Introduction To Degradation Of Lipids And Ketone Bodies Metabolism
Content: 1. Introduction to degradation of lipids and ketone bodies metabolism 2. Lipids as source of energy – degradation of TAG in cells, β-oxidation of fatty acids 3. Synthesis and utilisation of ketone bodies _ Triacylglycerol (TAG) contain huge amounts of chemical energy. It is very profitable to store energy in TAG because 1 g of water-free TAG stores 5 times more energy than 1 g of hydrated glycogen. Complete oxidation of 1 g of TAG yields 38 kJ, 1g of saccharides or proteins only 17 kJ. Man that weighs 70 kg has 400 000 kJ in his TAG (that weight approximately 10,5 kg). This reserve of energy makes us able to survive starving in weeks. TAG accumulate predominantly in adipocyte cytoplasm. There are more types of fatty acid oxidation. Individual types can be distinguished by different Greek letters. Greek letter denote atom in the fatty acid chain where reactions take place. β-oxidation is of major importance, it is localised in mitochondrial matrix. ω- and α- oxidation are localised in endoplasmic reticulum. Animal cells cannot convert fatty acids to glucose. Gluconeogenesis requires besides other things (1) energy, (2) carbon residues. Fatty acids are rich source of energy but they are not source of carbon residues (there is however one important exception, i.e. odd-numbered fatty acids). This is because cells are not able to convert AcCoA to neither pyruvate, nor OAA. Both carbons are split away as CO2. PDH is irreversible. Plant cells are capable of conversion of AcCoA to OAA in glyoxylate cycle. _ Lipids as source of energy – degradation of TAG in cells, β-oxidation of fatty acids Lipids are used for energy production, this process take place in 3 phases: 1) Lipid mobilisation – hydrolysis of TAG to FA and glycerol. FA and glycerol are transported Continue reading >>
Diabetes And Ketones
Tweet The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis. Ketones build up when there is insufficient insulin to help fuel the body’s cells. High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes. If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible. What are ketones? Ketones are an acid remaining when the body burns its own fat. When the body has insufficient insulin, it cannot get glucose from the blood into the body's cells to use as energy and will instead begin to burn fat. The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy. It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned. In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis. How do I test for ketones? Ketone testing can be carried out at home. The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels. You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago. Read about testing for ketones and how to interpret the results Who needs to be aware of ketones? The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis: Anyone dependent on insulin – such as all people Continue reading >>
Ketosis, Ketone Bodies, And Ketoacidosis – An Excerpt From Modern Nutritional Diseases, 2nd Edition
The following text is excerpted from Lipids (Chapter 8) of Modern Nutritional Diseases, 2nd Edition. Ketone Bodies and Ketosis: Ketones are organic chemicals in which an interior carbon in a molecule forms a double bond with an oxygen molecule. Acetone, a familiar chemical, is the smallest ketone possible. It is composed of three carbons, with the double bond to oxygen on the middle carbon. Biological ketone bodies include acetone, larger ketones, and biochemicals that can become ketones. The most important of the ketone bodies are hydroxybutyrate and acetoacetate, both of which are formed from condensation of two acetyl CoA molecules. Acetone is formed from a nonenzymatic decarboxylation of acetoacetate. Ketone bodies are fuel molecules that can be used for energy by all organs of the body except the liver. The production of ketone bodies is a normal, natural, and important biochemical pathway in animal biochemistry (17, p. 577). Small quantities of ketone bodies are always present in the blood, with the quantity increasing as hours without food increase. During fasting or carbohydrate deprivation, larger amounts of ketone bodies are produced to provide the energy that is normally provided by glucose. Excessive levels of circulating ketone bodies can result in ketosis, a condition in which the quantity of circulating ketone bodies is greater than the quantity the organs and tissues of the body need for energy. People who go on extremely low-carbohydrate diets to lose a large excess of body fat usually go into a mild ketosis that moderates as weight is lost. There is no scientific evidence that a low-carbohydrate diet is capable of producing sufficient ketone bodies to be harmful. Excess ketone bodies are excreted by the kidneys and lungs. Exhaled acetone gives the brea Continue reading >>
How Much Do You Know About Ketones?
Most people with diabetes – and anyone who has read about low-carbohydrate diets – has probably heard of ketones, but how many people really know what they are? Messages about ketones can be confusing: Some sources say they are toxic and dangerous, while others suggest that ketones are a positive sign of weight loss through fat burning. When you have diabetes, it’s important to know the facts about ketones, as well as when to check for them, how to check for them, and what to do if you detect them. Take this quiz to see how much you know about ketones. (You’ll find answers later in this article.) Q 1. What are ketones? A. Acids created in the liver. B. Fats released when blood glucose is high. C. Antifungal drugs. D. Hormones that are created only under special circumstances. 2. Which of the following statements about ketones is not true? A. Consuming very little carbohydrate can lead to the formation of ketones. B. Trace levels of ketones are generally harmless. C. There must be a very low level of insulin for dangerous amounts of ketones to form. D. Ketones cause weight loss. 3. All persons with diabetes should check for ketones when their blood glucose level is over 240 mg/dl. TRUE FALSE 4. Ketones can only be measured in the urine. TRUE FALSE 5. What is the role of ketones in the development of diabetic ketoacidosis (DKA), the acute diabetes complication characterized by high levels of ketones, high blood glucose, and dehydration? (More than one answer may be correct.) A. Ketones make the blood more acid. B. High levels of ketones cause dehydration. C. Ketones play a role in electrolyte loss. D. Ketones raise blood glucose. 6. People with Type 2 diabetes cannot develop diabetic ketoacidosis. TRUE FALSE 7. What steps are necessary to reduce ketones in the bod Continue reading >>
The term “ketone bodies” refers primarily to two compounds: acetoacetate and β‐hydroxy‐butyrate, which are formed from acetyl‐CoA when the supply of TCA‐cycle intermediates is low, such as in periods of prolonged fasting. They can substitute for glucose in skeletal muscle, and, to some extent, in the brain. The first step in ketone body formation is the condensation of two molecules of acetyl‐CoA in a reverse of the thiolase reaction. The product, acetoacetyl‐CoA, accepts another acetyl group from acetyl‐CoA to form β‐hydroxy‐β‐hydroxymethylglutaryl‐CoA (HMG‐CoA). HMG‐CoA has several purposes: It serves as the initial compound for cholesterol synthesis or it can be cleaved to acetoacetate and acetyl‐CoA. Acetoacetate can be reduced to β‐hydroxybutyrate or can be exported directly to the bloodstream. Acetoacetate and β‐hydroxybutyrate circulate in the blood to provide energy to the tissues. Acetoacetate can also spontaneously decarboxylate to form acetone: Although acetone is a very minor product of normal metabolism, diabetics whose disease is not well‐managed often have high levels of ketone bodies in their circulation. The acetone that is formed from decarboxylation of acetoacetate is excreted through the lungs, causing characteristic “acetone breath.” Continue reading >>
Also found in: Dictionary, Thesaurus, Legal, Financial, Encyclopedia, Wikipedia. Related to ketone bodies: ketosis ketone [ke´tōn] any compound containing the carbonyl group, C=O, and having hydrocarbon groups attached to the carbonyl carbon, i.e., the carbonyl group is within a chain of carbon atoms. ketone bodies the substances acetone, acetoacetic acid, and β-hydroxybutyric acid; except for acetone (which may arise spontaneously from acetoacetic acid), they are normal metabolic products of lipid and pyruvate within the liver, and are oxidized by muscles. Excessive production leads to urinary excretion of these bodies, as in diabetes mellitus; see also ketosis. Called also acetone bodies. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. ketone bodies two products of lipid pyruvate metabolism, beta-hydroxybutyric acid and aminoacetic acid, from which acetone may arise spontaneously. Ketone bodies are produced from acetyl-CoA in the liver and are oxidized by the muscles. Excessive production leads to their excretion in urine, as in diabetes mellitus. Also called acetone bodies. Ketones, Blood and Urine Synonym/acronym: Ketone bodies, acetoacetate, acetone. Common use To investigate diabetes as the cause of ketoacidosis and monitor therapeutic interventions. Specimen Serum (1 mL) collected from gold-, red-, or red/gray-top tube. Urine (5 mL), random or timed specimen, collected in a clean plastic collection container. Normal findings (Method: Colorimetric nitroprusside reaction) Negative. Description Ketone bodies refer to the three intermediate products of metabolism: acetone, acetoacetic acid, and β-hydroxybutyrate. Even though β-hydroxybutyrate Continue reading >>
Ketone Bodies: A Review Of Physiology, Pathophysiology And Application Of Monitoring To Diabetes.
Abstract Ketone bodies are produced by the liver and used peripherally as an energy source when glucose is not readily available. The two main ketone bodies are acetoacetate (AcAc) and 3-beta-hydroxybutyrate (3HB), while acetone is the third, and least abundant, ketone body. Ketones are always present in the blood and their levels increase during fasting and prolonged exercise. They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones. In diabetic ketoacidosis (DKA), high levels of ketones are produced in response to low insulin levels and high levels of counterregulatory hormones. In acute DKA, the ketone body ratio (3HB:AcAc) rises from normal (1:1) to as high as 10:1. In response to insulin therapy, 3HB levels commonly decrease long before AcAc levels. The frequently employed nitroprusside test only detects AcAc in blood and urine. This test is inconvenient, does not assess the best indicator of ketone body levels (3HB), provides only a semiquantitative assessment of ketone levels and is associated with false-positive results. Recently, inexpensive quantitative tests of 3HB levels have become available for use with small blood samples (5-25 microl). These tests offer new options for monitoring and treating diabetes and other states characterized by the abnormal metabolism of ketone bodies. Continue reading >>
Ketone Bodies Formed In The Liver Are Exported To Other Organs
Ketone Bodies In human beings and most other mammals, acetyl-CoA formed in the liver during oxidation of fatty acids may enter the citric acid cycle (stage 2 of Fig. 16-7) or it may be converted to the "ketone bodies" acetoacetate, D-β-hydroxybutyrate, and acetone for export to other tissues. (The term "bodies" is a historical artifact; these compounds are soluble in blood and urine.) Acetone, produced in smaller quantities than the other ketone bodies, is exhaled. Acetoacetate and D-β-hydroxybutyrate are transported by the blood to the extrahepatic tissues, where they are oxidized via the citric acid cycle to provide much of the energy required by tissues such as skeletal and heart muscle and the renal cortex. The brain, which normally prefers glucose as a fuel, can adapt to the use of acetoacetate or D-β-hydroxybutyrate under starvation conditions, when glucose is unavailable. A major determinant of the pathway taken by acetyl-CoA in liver mitochondria is the availability of oxaloacetate to initiate entry of acetyl-CoA into the citric acid cycle. Under some circumstances (such as starvation) oxaloacetate is drawn out of the citric acid cycle for use in synthesizing glucose. When the oxaloacetate concentration is very low, little acetyl-CoA enters the cycle, and ketone body formation is favored. The production and export of ketone bodies from the liver to extrahepatic tissues allows continued oxidation of fatty acids in the liver when acetyl-CoA is not being oxidized via the citric acid cycle. Overproduction of ketone bodies can occur in conditions of severe starvation and in uncontrolled diabetes. The first step in formation of acetoacetate in the liver (Fig. 16-16) is the enzymatic condensation of two molecules of acetyl-CoA, catalyzed by thiolase; this is simply Continue reading >>
Ketosis, Ketones, And How It All Works
Ketosis is a process that the body does on an everyday basis, regardless of the number of carbs you eat. Your body adapts to what is put in it, processing different types of nutrients into the fuels that it needs. Proteins, fats, and carbs can all be processed for use. Eating a low carb, high fat diet just ramps up this process, which is a normal and safe chemical reaction. When you eat carbohydrate based foods or excess amounts of protein, your body will break this down into sugar – known as glucose. Why? Glucose is needed in the creation of ATP (an energy molecule), which is a fuel that is needed for the daily activities and maintenance inside our bodies. If you’ve ever used our keto calculator to determine your caloric needs, you will see that your body uses up quite a lot of calories. It’s true, our bodies use up much of the nutrients we intake just to maintain itself on a daily basis. If you eat enough food, there will likely be an excess of glucose that your body doesn’t need. There are two main things that happen to excess glucose if your body doesn’t need it: Glycogenesis. Excess glucose will be converted to glycogen and stored in your liver and muscles. Estimates show that only about half of your daily energy can be stored as glycogen. Lipogenesis. If there’s already enough glycogen in your muscles and liver, any extra glucose will be converted into fats and stored. So, what happens to you once your body has no more glucose or glycogen? Ketosis happens. When your body has no access to food, like when you are sleeping or when you are on a ketogenic diet, the body will burn fat and create molecules called ketones. We can thank our body’s ability to switch metabolic pathways for that. These ketones are created when the body breaks down fats, creating Continue reading >>