How Do I Control Type 1 Diabetes?
Others have already mentioned that type 1 diabetes is because the body does not produce insulin. In fact, the body’s immune system thinks the beta cells producing insulin are alien cells. Hence, it attacks and kills them. Until science figures out how to fix/fool the immune system into letting the beta cells live, type 1 diabetics have to take insulin to control blood sugar levels. Given that, what can one do to maintain “normal” blood sugar levels? I define “normal” blood sugar levels as a HbA1c of < 7 (others may have different definitions). I pick HbA1c < 7 because the DCCT study in the US has determined that maintaining an HbA1c < 7 helps keep long term complications at bay. I consider the following essential while trying to maintain an HbA1c < 7: Understand the disease. How it is caused? Can it be reversed? You have to accept that there is no alternative but to take insulin shots. I tend to think of type 1 diabetes as a spouse that I cannot divorce. If I “misbehave”, this spouse gets upset. Regular blood sugar monitoring. Buy a glucometer and check your blood sugar levels regularly. There is no better tool in keeping something in check - measure to know the current blood sugar level and make adjustments as required Learn to carb count and adjust insulin dosages. Initially, your doctor will give you a diet plan and suggest insulin dosages. Those are a good starting point. But, to lead a flexible lifestyle, you need to understand what’s happening. Master carb counting and adjusting insulin dosages. This gives one the much needed flexibility in leading a modern lifestyle. For convenience, you can explore using the insulin pump, a continuous glucose monitoring device; or a combination closed loop system. However, a good understanding of carb counting an Continue reading >>
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 >>
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 >>
Diabetic Ketoacidosis Explained
Twitter Summary: DKA - a major complication of #diabetes – we describe what it is, symptoms, who’s at risk, prevention + treatment! One of the most notorious complications of diabetes is diabetic ketoacidosis, or DKA. First described in the late 19th century, DKA represented something close to the ultimate diabetes emergency: In just 24 hours, people can experience an onset of severe symptoms, all leading to coma or death. But DKA also represents one of the great triumphs of the revolution in diabetes care over the last century. Before the discovery of insulin in 1920, DKA was almost invariably fatal, but the mortality rate for DKA dropped to below 30 percent within 10 years, and now fewer than 1 percent of those who develop DKA die from it, provided they get adequate care in time. Don’t skip over that last phrase, because it’s crucial: DKA is very treatable, but only as long as it’s diagnosed promptly and patients understand the risk. Table of Contents: What are the symptoms of DKA? Does DKA occur in both type 1 and type 2 diabetes? What Can Patients do to Prevent DKA? What is DKA? Insulin plays a critical role in the body’s functioning: it tells cells to absorb the glucose in the blood so that the body can use it for energy. When there’s no insulin to take that glucose out of the blood, high blood sugar (hyperglycemia) results. The body will also start burning fatty acids for energy, since it can’t get that energy from glucose. To make fatty acids usable for energy, the liver has to convert them into compounds known as ketones, and these ketones make the blood more acidic. DKA results when acid levels get too high in the blood. There are other issues too, as DKA also often leads to the overproduction and release of hormones like glucagon and adrenaline Continue reading >>
Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>
Diabetes: What Is Ketoacidosis And How Can Be Avoided & Treated?
Good question! According to Wikipedia: Diabetic ketoacidosis is a potentially life-threatening complication in patients with diabetes mellitus. In order to define ketoacidosis a little better, let's go back to the source: diabetes. Someone who is diabetic is unable to produce insulin, a hormone necessary for the transfer of sugar from the bloodstream to the cells, which in turn produce energy. If this progression is disrupted, through lack of insulin for example, the body has to try to compensate by creating energy elsewhere. And so the body starts to burn fat and muscle to meet its energy needs. Unfortunately, this chemical reaction produces molecules known as ketone bodies. In small quantities, these are fine, and it is in fact normal to have traces of them in your blood (approximately 1mg/dl). However, if the quantity of ketones surpasses this threshold by too much, it starts to affect the pH of your blood (which becomes progressively more acidic). Even the slightest drop in pH can have dangerous effects: as the quantity of the ketones in your blood increases, and the blood pH diminishes, your kidneys start having problems. Eventually, if the ketoacidosis is left untreated, your kidneys can fail and you can die from dehydration, tachycardia and hypotension. A number of other symptoms can appear in extreme cases. Fortunately for us, the quantity of ketones has to be consequential, and it usually takes a while before individuals start manifesting symptoms. In my case, my diabetes went undiagnosed for a month and a half before it was discovered, and even then my ketone levels were relatively normal. If you're a diabetic, ketoacidosis can be easily avoided by controlling your blood sugar levels and maintaining a healthy lifestyle. Some doctors, preferring to stay on the Continue reading >>
How To Prevent Diabetic Ketoacidosis
Diabetes, if not properly managed, can have nasty consequences, including vision loss, amputations, heart disease and stroke or kidney failure. Diabetic ketoacidosis, or DKA, is another one of those consequences, according to Dr. Linda Hermiller, an endocrinologist and diabetes expert at St. Elizabeth’s Regional Diabetes Center in Covington. Diabetes causes blood sugar levels to climb too high because the body either can’t make insulin in order to break down the sugar from food to fuel cell activity (Type 1 diabetes) or because the body can’t properly utilize the insulin it does have (Type 2). Over time, excessively high blood sugar levels lead to a host of complications. What is DKA? DKA occurs when the body starts breaking down stored fat for fuel because it can’t utilize insulin to break down sugar. When fat is metabolized, it produces chemicals called ketones that build up in the blood, and those ketones cause the blood to become acidic. High ketone levels are an indication that diabetes isn’t being properly managed. They’re also extremely dangerous. DKA, if not recognized and treated quickly, can be fatal, according to Dr. Hermiller. “DKA is an acute metabolic emergency that more commonly happens in patients with Type 1 diabetes, but in unique situations may occur in those with Type 2,” Dr. Hermiller said. Common causes of DKA In many cases, people develop DKA after a stomach bug or other illness; sometimes it occurs when people aren’t taking their insulin as directed, or they aren’t taking enough insulin, she said. Blood sugar levels rise sharply, and the body begins producing ketones. The best way to prevent DKA is good diabetes management, including checking blood sugar frequently. Guidelines call for checking for ketones in the urine (you ca Continue reading >>
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 >>
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 . 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 . 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 >>
Diabetes With Ketone Bodies In Cats
Diabetes Mellitus with Ketoacidosis in Cats The term “ketoacidosis” refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies.” Meanwhile, diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. In diabetes with ketoacidosis, ketoacidosis immediately follows diabetes. It should be considered a dire emergency, one in which immediate treatment is required to save the life of the animal. Typically, the type of condition affects older cats; in addition, female cats are more prone diabetes with ketoacidosis than males. Symptoms and Types Weakness Lethargy Depression Lack of appetite (anorexia) Muscle wasting Rough hair coat Dehydration Dandruff Sweet breath odor Causes Although the ketoacidosis is ultimately brought on by the cat's insulin dependency due to diabetes mellitus, underlying factors include stress, surgery, and infections of the skin, respiratory, and urinary tract systems. Concurrent diseases such as heart failure, kidney failure, asthma, cancer may also lead to this type of condition. Diagnosis You will need to give a thorough history of your cat’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count (CBC). The most consistent finding in patients with diabetes is higher than normal levels of glucose in the blood. If infection is present, white blood cell count will also high. Other findings may include: high liver enzymes, high blood cholesterol levels, accumulation in the blood of nitrogenous waste products (urea) that are usually excreted in the urine (azotemia), low sodium levels Continue reading >>
Ketoacidosis Associated With Low-carbohydrate Diet In A Non-diabetic Lactating Woman: A Case Report
Go to: Case presentation A 32-year-old white woman presented to our county hospital with a history of nausea, vomiting, heart palpitations, trembling and extremity spasms. She had started a strict LCHF diet, with an estimated carbohydrate intake of less than 20g per day, 10 days before admittance, lost 4 kilograms and had felt growing malaise. She was breastfeeding her son of 10 months of age. She continuously denied any alcohol or drug intake. She had a past medical history of hypothyreosis and had a family history of high blood pressure but not for diabetes. She took acetaminophen occasionally but no other medications. The initial examination in the emergency department revealed an unaffected woman with respiratory rate of 12 breaths per minute, oxygen saturation 96% on room air, body temperature 36.3°C, pulse 102 beats per minute and blood pressure of 110/80mmHg. Nothing abnormal was revealed on examination of her heart, lungs, abdomen and thyroid gland. An arterial blood gas was taken. It revealed pH 7.20, base excess (BE) −19, partial pressure of carbon dioxide (pCO2) 2.8 kPa, glucose 3.8mmol/l and lactate 1.0mmol/l. Her blood ketones were 7.1mmol/l (reference 0 to 0.5mmol/l). No genetic testing of any kind was performed. The primary diagnosis was thought to be ketoacidosis due to starvation induced by the LCHF diet but blood samples for s-paracetamol, s-salicylate, s-ethanol, s-methanol, s-ethylene glycol, kidney function, diabetic autoantibodies, plasma cortisol (p-cortisol) and tests for thyroid function were added. She was admitted to our medical ward, given an intramuscular vitamin B injection and started on a 10% glucose infusion. In total 3L of glucose were infused, with an infusion rate of 125mL/hour, during 48 hours. The following day, after glucose inf Continue reading >>
Would You Eat Food That Was Genetically Modified?
Not only do I eat GMOs, I willingly inject myself with GMOs 5–8 times a day! It is my secret to a long life. “What?” I can hear your gasping disbelief from here. “Why would you do something so harmful to yourself? Don't you realize how BAD GMOS are?” I have Type 1 diabetes. For those of you who don't know, it is an autoimmune disease that causes the islet cells of the pancreas (they are responsible for producing insulin) to die off. When your body cannot produce its own insulin, you must inject man made insulin several times a day. If you don't, your blood glucose levels will rise to dangerous levels and your blood chemistry goes wonky (scientific medical term). Without insulin, your blood begins burning fat and muscle for fuel instead of carbs. The acidic byproduct is called ketones. You may have heard of low-carb diets that suggest you check your urine for ketones and applaud you if you manage to get a pink square on the ketone strip. However, with Type 1, that pink square is terrifying. It means you are going into ketoacidosis, which is a life threatening emergency. Without treatment, you will die. Quickly. If you have Type 1 diabetes (only loosely related to Type 2 diabetes, which is what most people recognize as diabetes) you must be on insulin. No matter how healthy your diet. No matter how few carbs you eat. No matter how thin and fit you are. You must be on insulin. Commercially produced insulin used to be made from cows and pigs. Now it is created in a lab, by genetically modifying yeast spores. Lab created insulin is the perfect example of a genetically modified organism. Without GMOS, I would be dead within a week or two. Yes, I allow GMOS into my body. Gladly. Continue reading >>
> Hyperglycemia And Diabetic Ketoacidosis
When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>
Is The Ketogenic Diet Safe For People With Diabetes?
Is The Ketogenic Diet Safe for People with Diabetes? If you’ve been diagnosed with diabetes, chances are you’re looking for simple yet effective ways to control your blood sugar. And, if at all possible, without the use of daily shots or medications. As I’ve mentioned in earlier blog posts, exercise is one of the best natural ways to manage blood glucose. But perhaps the most obvious way to keep blood sugar at a safe and consistent level without insulin is to pay special attention to what you eat. And, in the case of diabetes, limiting your carbohydrate intake may be the key. What Is the Keto Diet? At first glance the ketogenic (keto) diet may seem like a crazy idea for type 2 diabetics. After all, many patients are put on diets to help them lose weight. The keto diet is high in fat, but it is very low in carbs, and this combination can help change the way your body stores and uses energy. With this diet your body converts fat instead of sugar into energy, which can improve blood glucose levels while reducing the need for insulin. Ketosis VS Ketoacidosis Ketosis and ketoacidosis are two very different things, which are often confused. But it’s very important you understand the difference. What is ketoacidosis? Ketoacidosis (KA) is a life-threatening condition in which your body doesn’t make enough insulin. This causes you to have dangerously high levels of ketones (substances occurring when the body uses fat stores for energy) and blood sugar. The combination of both makes your blood incredibly acidic, and this can, in turn, change the normal functioning of your internal organs such as your liver and kidneys. Patients suffering from ketoacidosis must get treatment immediately or they could slip into a coma and even die. Ketoacidosis can develop in less than 24 Continue reading >>
Diabetic Ketoacidosis (dka)
Topic Overview Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. What causes DKA? Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. What are the symptoms? Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Blurred vision. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. How is DKA diagnosed? Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin Continue reading >>