diabetestalk.net

How Dangerous Is Ketoacidosis

What Is The Difference Between Ketosis And Ketoacidosis?

What Is The Difference Between Ketosis And Ketoacidosis?

Ketoacidosis is a dangerous condition, where toxic levels of ketone bodies build up in the blood because the body is not producing insulin. Ketosis, on the other hand, results when the body has exhausted its stored glycogen and begins to burn fatty tissue for energy. Ketosis The process of ketosis is the basis of the many low-carb diets marketed to the public. In ketosis, the body does not have sufficient glucose or glycogen available to give cells what they need to create energy. The body then turns to fat cells as an energy source. Ketone bodies in the bloodstream are a natural product of this process. These diets work, and ketosis is achieved, when carbohydrates are essentially eliminated from the diet. With minimal carbohydrate intake, there is little sugar to convert to glycogen. Without glycogen, the body breaks down and excretes fat cells, leaving ketones behind in the blood. In an ideal situation, this results in weight loss. Ketones in the body can be toxic in high enough concentrations. The body often has small amounts of ketones in the bloodstream, including during the overnight period. This is a mild, natural reaction, with low levels of ketones (blood ketones at 1-3 millimolar) and a normal pH of 5, that reverses in the morning when the nightly fast is broken. Low levels of ketones in the bloodstream do not represent a danger to health. Ketoacidosis Ketoacidosis occurs when blood sugar levels are high (meaning they are not being metabolized properly in the absence of insulin) and the body is experiencing dehydration. This means the normally small concentration of ketones in the bloodstream becomes much larger. Ketoacidosis is a pathological condition where the body cannot control the level of ketones building up in the blood. The ketones are being excreted Continue reading >>

High Blood Sugars (ketoacidosis)

High Blood Sugars (ketoacidosis)

Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome Severe high blood sugars, ketosis (the presence of ketones prior to acidification of the blood), and ketoacidosis (DKA) are serious and potentially life-threatening medical problems which can occur in diabetes. High blood sugars become life-threatening in Type 1 or long-term Type 2 diabetes only when that person does not receive enough insulin from injections or an insulin pump. This can be caused by skipping insulin or not receiving enough insulin when large amounts are required due to an infection or other major stress. Ketoacidosis surprisingly occurs almost as often in Type 2 diabetes as it does in Type 1. However, people with Type 2 diabetes also encounter another dangerous condition called hyperglycemic hyperosmolar syndrome, which is roughly translated as thick blood due to very high blood sugars. Here, coma and death can occur simply because the blood sugar is so high. The blood will have ketones at higher levels but does not become acidotic. HHS usually occurs with blood sugar readings above 700 mg/dl (40 mmol) as the brain and other functions begin to shut down. When insulin levels are low, the body cannot use glucose present at high levels in the blood. The body then starts burning excessive amounts of fat which causes the blood to become acidic as excess ketone byproducts are produced. Even though the blood pH which measures acidity only drops from its normal level of 7.4 down to 7.1 or 7.0, this small drop is enough to inactivate enzymes that depend on a precise acid-base balance to operate. High blood sugars and ketoacidosis can be triggered by: not taking insulin severe infection severe illness bad insulin In Type 1 diabetes, ketoacidosis often occurs under the duress of an infection, and is also freque Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

It really is a sad fact that some experts add more to the confusion surrounding health and nutrition then they do to clear things up. One such area is that of ketosis vs ketoacidosis. While you may be unfamiliar with these terms, you will most certainly know about low carb and very low carb diets, and it is likely you’ve heard health professionals warning against the dangerous side-efffects of low-carbing. Well, ketosis and ketoacidosis are often quoted as two of those dangerous side-effects. This advice, however, is partly misinformed, partly overcautious. I read about Jimmy’s (Livin’ La Vida Low-Carb) experience recently when he went to give blood. He struck up a conversation with the type 2 diabetic nurse, and talk turned to eating a low carb diet. Her immediate response was that ketosis is a dangerous condition to be avoided. This is a pretty common opinion echoed by many health professionals. Here is what WebMD say on the subject of ketosis; Unhealthy metabolic state (ketosis). Low-carb diets can cause your body to go into a dangerous metabolic state called ketosis since your body burns fat instead of glucose for energy. During ketosis, the body forms substances known as ketones, which can cause organs to fail and result in gout, kidney stones, or kidney failure. Ketones can also dull a person’s appetite, cause nausea and bad breath. Ketosis can be prevented by eating at least 100 grams of carbohydrates a day. It is hardly surprising that the general public are confused, when health professionals and mainstream websites like WebMD make statements like this. And that’s only two examples. If this is all starting to sound a bit worrying, let me clarify things for you by firstly defining the difference between ketosis and ketoacidosis. Ketosis vs Ketoacidosis Continue reading >>

Ketoacidosis

Ketoacidosis

Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter[1], may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly. Diabetics of all species therefore need to be checked for ketones with urine testing stix, available at any pharmacy, whenever insulin level may be too low, and any of the following signs or triggers are present: Ketone Monitoring Needed: Little or no insulin in last 12 hours High blood sugar over 16 mmol/L or 300 mg/dL (though with low insulin, lower as well...) Dehydration (skin doesn't jump back after pulling a bit gums are tacky or dry)[2] Not eating for over 12 hours due to Inappetance or Fasting Vomiting Lethargy Infection or illness High stress levels Breath smells like acetone (nail-polish remover) or fruit. Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. Possible False Urine Ketone Test Results Drugs and Supplements Valproic Acid (brand names) Depakene, Depakote, Divalproex Sodium[3] Positive. Common use: Treatment of epilepsy. Cefixime/Suprax[4] Positive with nitroprusside-based urine testing. Common use: Antibiotic. Levadopa Metabolites[5] Positive with high concentrations[6]. Tricyclic Ring Compounds[7][8] Positive. Commo Continue reading >>

Is Keto Healthy? Ketosis Vs Ketoacidosis

Is Keto Healthy? Ketosis Vs Ketoacidosis

Is Keto Healthy? Ketosis vs Ketoacidosis When looking at a ketogenic diet and ketosis, it’s common for some people to confuse the process with a harmful, more extreme version of this state known as diabetic ketoacidosis. But there are a lot of misconceptions out there about ketosis vs ketoacidosis, and it’s time to shed some light on the subject by looking at the (very big) differences between the two. An Overview of Ketosis A ketogenic, or keto, diet is centered around the process of ketosis, so it’s important to understand exactly what ketosis is first before we get into whether or not it’s safe (spoiler: it is): Ketosis is a metabolic state where the body is primarily using fat for energy instead of carbohydrates. Burning carbohydrates (glucose) for energy is the default function of the body, so if glucose is available, the body will use that first. But during ketosis, the body is using ketones instead of glucose. This is an amazing survival adaptation by the body for handling periods of famine or fasting, extreme exercise, or anything else that leaves the body without enough glucose for fuel. Those eating a ketogenic diet purposely limit their carb intake (usually between 20 and 50 grams per day) to facilitate this response. That’s why the keto diet focuses on very low carb intake, moderate to low protein intake, and high intakes of dietary fats. Lower protein is important because it prevents the body from pulling your lean muscle mass for energy and instead turns to fat. Ketone bodies are released during ketosis and are created by the liver from fatty acids. These ketones are then used by the body to power all of its biggest organs, including the brain, and they have many benefits for the body we’ll get into later. But first, let’s address a common mi Continue reading >>

Pegaspargase: A Rare But Dangerous Cause Of Diabetic Ketoacidosis

Pegaspargase: A Rare But Dangerous Cause Of Diabetic Ketoacidosis

Abstract: Background: L-asparginase is reported to cause hyperglycemia in approximately 10% of patients with acute lymphoblastic leukemia (ALL). Pegaspargase, a form of L-asparginase linked with polyethylene glycol, has been associated with less hyperglycemia than native L-asparginase (1). Clinical Case: A 32-year-old Hispanic male was diagnosed with ALL in August 2015. His body mass index was 26 kg/m2 and physical exam was notable for acanthosis nigricans on the neck. Family history was negative for diabetes or endocrine disorders. A few days later, he was admitted for chemotherapy with HyperCVAD and asparagase and found to have a white blood cell count (WBC) of 102.6 k/ul on labs. Due to high risk for tumor lysis syndrome, he underwent leukopheresis for two days and received prednisone 40 mg PO daily for three days. After WBC improved, chemotherapy was initiated and he received dexamethasone 40 mg PO daily on days 1 to 4 and days 11 to 14 as well as pegaspargase (2500 units/m2, intravenously) on day 11. He received one dose of hydrocortisone 100 mg intravenously prior to pegaspargase dose on day 11. While receiving dexamethasone on days 1 to 4, blood glucose (BG) increased to 211 mg/dl but returned to normal after steroids were stopped. However, during days 11 to 14 of treatment, after receiving the doses of hydrocortisone and pegaspargase and two doses of dexamethasone, his BG was 397 mg/dl on routine labs. On the following day, BG was >600 mg/dl and he had an anion gap of 19. Urinalysis revealed ketonuria and glucosuria. He was transferred to the intensive care unit for diabetic ketoacidosis (DKA) and started on IV insulin and fluid therapy. He finished his course of dexamethasone the following day. BG levels and anion gap improved. He was transitioned to subcutaneo Continue reading >>

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 >>

‘i Was 26 And Most Type 1 Diabetics Are Diagnosed In Childhood': The Deadly Danger Too Many Diabetics Aren't Warned About

‘i Was 26 And Most Type 1 Diabetics Are Diagnosed In Childhood': The Deadly Danger Too Many Diabetics Aren't Warned About

Hannah Postles discovered she had type 1 diabetes after going to A&E with blurred vision. It wasn’t her only symptom. For the previous three weeks, she’d been thirsty, drinking two bottles of water at lunch, had lost weight and felt run down. Scroll down for video ‘My boss suggested I might have diabetes after looking up my symptoms online, but my GP seemed to dismiss it because of my age,’ says Hannah, a press officer for the University of Sheffield. ‘I was 26 and most type 1 diabetics are diagnosed in childhood.’ Luckily, Hannah spoke to a doctor friend who told her to go to A&E, where she was tested for diabetes, and immediately put on an insulin drip. Type 1 diabetes occurs when the body doesn’t make insulin, the hormone that regulates glucose levels in the blood. Typically, people with type 1 diabetes are diagnosed around the age of 12 — although occasionally adults are diagnosed in later life. Type 2 diabetes, which can be diagnosed at any age, occurs when the body doesn’t produce enough insulin, or the insulin itself does not work properly. Not only did Hannah have diabetes, her blood sugar levels were so out of control by the time she was diagnosed that she had developed diabetic ketoacidosis, a life-threatening condition when blood glucose levels remain persistently high for days or weeks. The condition can be caused by illness or infection or by the mismanagement of diabetes — which, as Hannah, now 29, discovered, can be the result of not knowing you have it. Symptoms include vomiting, headaches, abdominal pain and, if left too long, coma and even death. Had Hannah not gone to A&E, she might have died. In July 2012, new mother Nicky Rigby, 26, from the Wirral, did die from undiagnosed type 1 diabetes. She’d assumed her chronic tiredness a 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 >>

Ketosis Vs. Ketoacidosis: What You Should Know

Ketosis Vs. Ketoacidosis: What You Should Know

Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin. Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production. Ketosis is the presence of ketones. It’s not harmful. You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you have ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat. Some people choose a low-carb diet to help with weight loss. While there is some controversy over their safety, low-carb diets are generally fine. Talk to your doctor before beginning any extreme diet plan. DKA is the leading cause of death in people under 24 years old who have diabetes. The overall death rate for ketoacidosis is 2 to 5 percent. People under the age of 30 make up 36 percent of DKA cases. Twenty-seven percent of people with DKA are between the ages of 30 and 50, 23 percent are between the ages of 51 and 70, and 14 percent are over the age of 70. Ketosis may cause bad breath. Ket Continue reading >>

Difference Between Ketosis And Diabetic Ketoacidosis

Difference Between Ketosis And Diabetic Ketoacidosis

There is a distinct difference between Diabetic Ketoacidosis, Nutritional Ketosis, and Exogenous Ketones. Diabetic ketoacidosis is a dangerous state that occurs in the absence of insulin. What happens is your blood sugar levels rise, but it’s insulin that needs to pull the sugar out of the blood into the cells. This absence of insulin results in the blood not being able to deplete itself of the sugar, and the sugar will not be absorbed into the cells. So your body thinks it’s starved of energy in the absence of blood sugars and begins producing abnormal amounts of ketones. There is nothing to manage the production of ketones and blood sugar, ending up with very high levels of both, which can be quite dangerous. Diabetic ketoacidosis can’t happen if there is enough insulin present in the body. Nutritional ketosis is the process of your body breaking down fat as a source of fuel and creating ketones. This only happens when following a low carbohydrate – high fat diet. Exogenous ketones, such as KETO//OS, are ketone bodies that you can take and absorb into your body without being in a state of nutritional ketosis. Taking exogenous ketones will elevate your level of ketones for 3 – 6 hours. There are many benefits to taking exogenous ketones as well. So is a ketone supplement, such as KETO//OS, safe to take for diabetics? If you are a controlled diabetic, and you’ve been approved by your healthcare provider to take exogenous ketones. Then yes, it’s quite safe. And, there could be a great benefit due to the beneficial impact of insulin sensitivity that is associated with ketones and bhb (beta hydroxybutyrate). It’s important to remember to manage your blood ketone levels as much as you manage your blood sugar levels. Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

Duck Dodgers October 14, 2014 Peter, An article by Per Wikholm was published in this month’s LCHF Magasinet, where Per demonstrates that the Inuit could not have been in ketosis given that the scientific literature is abundantly clear, over and over again, that the Inuit consumed too much protein, and more importantly, Per debunks Stefansson’s claims for high fat with writing from his own books—Stef admitted in the pemmican recipes that Arctic caribou was too lean to make pemmican that supported ketosis. The most popular LCHF bloggers in Sweden, Andreas Eenfeldt/Diet Doctor and Annika Dahlquist have reluctantly agreed with Per’s findings—admitting that the Inuit were likely not ketogenic from their diet. I’ve put together a comprehensive review of the scientific literature regarding the Inuit, encompassing over two dozen studies, spanning 150 years, with references from explorers, including Stefansson. In the comments section of that post, Per gives a brief overview of how he was able to prove Stefansson’s observations on high fat intake were flawed. The post is a review of all the available literature that I could find (over two dozen studies). But, the literature certainly does not in any way support ketosis from the Inuit diet due to such high protein consumption. As Per (and Stefansson) points out, the caribou is too lean and as the many quotes show, the Inuit were saving their blubber and fat for the long dark Winter to power their oil lamps and heat their igloos. Again and again, we see that in the literature, as even Stefansson admits this. As far as glycogen is concerned, their glycogen intake is probably not worth scrutinizing given the well-documented high protein consumption in every published study. It really is besides the point. But, interest Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Certainly a low carb approach doesn’t work with Type 1’s, right? What about the dangerous risks of hypoglycemia? Actually, this thinking is repeated over and over. Nothing could be further from the truth. In fact, those using a low carbohydrate high healthy fat (LCHF) approach have much more stable blood sugars, some nearly eliminating hypoglycemic episodes altogether. It really makes perfect sense. Why this reasoning is shunned, defies logic. Think about it…less (fast acting, blood-sugar-spiking) carbs, less insulin, less hypos. Before we go further in this post, I’d like you to read this powerfully compelling account of Dr. Keith Runyan, MD, a Nephrologist, who is a Type 1, and who successfully uses a carb restricted approach to manage his diabetes. Please read his story (link below). There is no way I could do this story justice in fewer words. The entire article is needed to understand its full impact. Afterwards, I would recommend his accompanying video. Nutritional Ketosis vs Diabetic Ketoacidosis Much of the backlash from mainstream beliefs regarding the use of carb restriction with Type 1’s stems from the lack of understanding about the difference between nutritional ketosis and diabetic ketoacidosis. I’m going to quote directly from Diabetes Daily Website. Here is the content of their article entitled “Why DKA and Nutritional Ketosis Are Not The Same”…(read the full article HERE) “There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstanding lie in the areas of: ketones that are produced in low-carb diets of generally less than 50g of carbs per day, which is low enough to put a person into a state of “nutritional ketosis.” ketones that are produced when a diabetic is in a state of Continue reading >>

Ketosis Vs Ketoacidosis: Is Keto Healthy?

Ketosis Vs Ketoacidosis: Is Keto Healthy?

Because the two terms look and sound similar, many people often confuse ketoacidosis with ketosis. These conditions have very different meanings and effects on the body. One is a highly dangerous condition while the other has been shown to help you lose weight, prevent disease, and improve cognitive function. Here’s what you need to know about the difference between ketoacidosis and ketosis. What is Ketoacidosis? Ketoacidosis or diabetic ketoacidosis (DKA) is a life-threatening condition that results as a complication of type one diabetes. It occurs when there are dangerously high levels of ketones and blood sugar present at the same time. Ketones are compounds that are produced when the body uses fat instead of sugar as fuel. The combination of having too many ketones and too much glucose present in your blood makes it become highly acidic. This can result in damage to the normal functioning of your kidney and liver. Ketoacidosis can develop in the body within 24 hours and requires immediate care. The condition commonly affects people with type one diabetes who do not produce enough or any insulin. People with type two diabetes can also develop the condition. Ketoacidosis can be triggered by improper diet, infection or illness, and not taking proper doses of insulin (in diabetic patients). Symptoms of ketoacidosis include nausea, vomiting, and abdominal pain. Other symptoms may include a fruity odor on the person’s breath. A person’s breathing may also become rapid and shallow (1). Ketoacidosis is the leading cause of death in people with diabetes under the age of 24. Approximately 36 percent of the people who develop ketoacidosis are under the age of 30 while 27 percent are between 30 and 50, 23 percent are between 51 and 70, and 14 percent are over 70. Studies Continue reading >>

Ketosis: Fear, Uncertainty And Doubt

Ketosis: Fear, Uncertainty And Doubt

Perhaps nothing is more damaging to the new low-carber than the intentional spread of fear, uncertainty and doubt regarding the state of ketosis compared to the dangerous state of ketoacidosis. The former is a natural and healthy state of existence, the latter is a condition that threatens the life of type 1 diabetics and type 2 diabetics whose disease has progressed to the point where their pancreatic beta cells can no longer produce insulin (ketoacidosis is also a risk for alcoholics). So if you’re not an alcoholic, a type 1 diabetic or a late-stage type 2 diabetic, fear of ketosis is misdirected. You should regard with suspicion anyone who confuses the two and warns you against a low-carb diet because they cannot tell the difference. The confusion between ketosis and ketoacidosis is a sign of a grave misunderstanding of basic biology (if not a complete lack of critical faculty). So too is the assumption that ketosis is the “early stage” of ketoacidosis or that “ketosis leads to ketoacidosis” in a person whose pancreas is still able to produce insulin. If you don’t trust me (and why should you), you should consider listening to some people who know a lot more about this than either you or I ever will: Nutritional ketosis is by definition a benign metabolic state… by contrast, ‘diabetic ketoacidosis’ is an unstable and dangerous condition that occurs when there is inadequate pancreatic insulin response to regulate serum B-OHB. This occurs only in type-1 diabetics or in late stage type-2 diabetics with advanced pancreatic burnout. (Dr. Phinney & Dr. Volek, The Art and Science of Low Carbohydrate Living, p.4) Later in the book (p.80), Phinney and Volek explain further: [Type-1 diabetics] need insulin injections not just to control blood glucose levels, Continue reading >>

More in ketosis