Ketoacidosis Versus Ketosis
Some medical professionals confuse ketoacidosis, an extremely abnormal form of ketosis, with the normal benign ketosis associated with ketogenic diets and fasting states in the body. They will then tell you that ketosis is dangerous. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com Ketosis is NOT Ketoacidosis The difference between the two conditions is a matter of volume and flow rate*: Benign nutritional ketosis is a controlled, insulin regulated process which results in a mild release of fatty acids and ketone body production in response to either a fast from food, or a reduction in carbohydrate intake. Ketoacidosis is driven by a lack of insulin in the body. Without insulin, blood sugar rises to high levels and stored fat streams from fat cells. This excess amount of fat metabolism results in the production of abnormal quantities of ketones. The combination of high blood sugar and high ketone levels can upset the normal acid/base balance in the blood and become dangerous. In order to reach a state of ketoacidosis, insulin levels must be so low that the regulation of blood sugar and fatty acid flow is impaired. *See this reference paper. Here's a table of the actual numbers to show the differences in magnitude: Body Condition Quantity of Ketones Being Produced After a meal: 0.1 mmol/L Overnight Fast: 0.3 mmol/L Ketogenic Diet (Nutritional ketosis): 1-8 mmol/L >20 Days Fasting: 10 mmol/L Uncontrolled Diabetes (Ketoacidosis): >20 mmol/L Here's a more detailed explanation: Fact 1: Every human body maintains the blood and cellular fluids within a very narrow range between being too acidic (low pH) and too basic (high pH). If the blood pH gets out of the normal range, either too low or too high, big problems happen. Fact 2: The Continue reading >>
Severe Ketoacidosis In A Patient With An Eating Disorder
Severe ketoacidosis with a blood pH below 7.0 is only rarely seen in other diseases except type 1 diabetes. This paper reports a case of severe ketoacidosis secondary to an eating disorder. A 46-year-old woman presented to the emergency department with an acute onset of shortness of breath. She has a history of an eating disorder, an anxiety disorder, and hypothyroidism. Her body mass index was 19. Examination of the initial vital signs revealed the following: pulse, 91 beats/min; body temperature, 34.9℃; respiratory rate, 35 breaths/min; oxygen saturation, 100% on room air; and blood pressure, 130/70 mmHg. Urinalysis revealed specific gravity of >1.030, pH of 5.5, negative results for glucose, and positive results for ketone bodies (>150 mg/dL). Her serum glucose level was 4.9 mmol/L. Venous blood gas analysis revealed the following: pH, 6.96; HCO3−, 5 mmol/L, pCO2, 22 mmHg; base deficit, 27 and anion gap, 21. the patient showed a high anion gap metabolic acidosis with proper respiratory compensation. Results of the blood analysis are shown in Table 1. The osmolar gap was 20, which suggested unmeasured anions. However, tests for ethanol, salicylate, ethylene glycol, and methanol levels were negative. The serum ketone test was positive. These laboratory parameters made us rule out diabetic ketoacidosis and alcoholic ketoacidosis as the cause of the metabolic acidosis. Initially, the patient received a 5% dextrose solution in normal saline (D5W NS). After 12 hours of hospitalization on D5W NS, venous blood gas analysis revealed improved results: pH, 7.18; HCO3−, 5 mmol/L; and pCO2, 13 mmHg, with a base deficit of 23. Initially, the family and the patient told us that the patient had been doing much better in the last 2 weeks regarding her eating habits. We asked he Continue reading >>
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 >>
Ketosis Vs. Ketoacidosis (dka): What Is The Difference?
Let’s break it down so that you can understand exactly what ketosis is and how it differs from ketoacidosis. But the states they refer to are nothing alike. In this case, maybe mistakes are understandable. Many people who believe that ketosis is dangerous are mixing it up with another state called "ketoacidosis." The two words do sound very similar. And some people simply make mistakes. Profit motives tend to muddy up the works when it comes to getting clear, factual information about your health. Well, there are a lot of individuals and companies which all have their own goals and motivations. Where do these misperceptions come from? Here’s the thing though … that is all misinformation. You then Googled something like, "low carb dangerous" and found a list of link-bait articles informing you that low-carb is a ketogenic diet, and ketosis is a dangerous metabolic state which can be fatal. And then maybe someone said something to you like, "What are you thinking? Low-carb is a dangerous diet." If you are thinking about starting a low-carb diet, maybe you have mentioned it to some of your family or friends. By the time you finish reading this article, you will understand why low-carb is a safe diet. Continue reading >>
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 >>
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 >>
How To Treat Ketoacidosis
Immediately drink a large amount of non-caloric or low caloric fluid. Continue to drink 8 to 12 oz. every 30 minutes. Diluted Gatorade, water with Nu-Salt™ and similar fluids are good because they help restore potassium lost because of high blood sugars. Take larger-than-normal correction boluses every 3 hours until the blood sugar is below 200 mg/dl (11 mmol) and ketones are negative. It will take much more rapid insulin than normal to bring blood sugars down when ketones are present in the urine or blood. Often, one and a half to two times the normal insulin dose for a high blood sugar will be necessary. Higher insulin doses than these will be needed if there is an infection or other major stress. If nausea becomes severe or last 4 hours or more, call your physician. If vomiting starts or you can no longer drink fluids, have a friend or family member call your physician immediately, then go directly to an emergency room for treatment. Never omit your insulin, even if you cannot eat. A reduced insulin dose might be needed, but only if your blood sugar is currently low. When high blood sugars or ketoacidosis happen, it is critical that you drink lots of fluid to prevent dehydration. Take extra amounts of Humalog, Novolog or Regular insulin to bring the blood sugars down. Children with severe ketoacidosis lose 10-15 % of their previous body weight (i.e., a 60 lb. child can lose 6 to 9 lbs. of weight) due to severe dehydration. Replacement of fluids should be monitored carefully. The dehydration is caused by excess urination due to high blood sugars and is quickly worsened when vomiting starts due to the ketoacidosis. The start of vomiting requires immediate attention at an ER or hospital where IV fluid replacement can begin. If only nausea is present and it is possible Continue reading >>
How To Treat Diabetic Ketoacidosis
1 Call emergency services. Diabetic ketoacidosis can be a life-threatening condition. If you are experiencing symptoms like your blood sugar not lowering, you should immediately call emergency services or visit the emergency room.[2] Symptoms that require you to call emergency services include severe nausea, being nauseous for four or more hours, vomiting, being unable to keep fluids down, inability to get your blood sugar levels down, or high levels of ketones in your urine.[3] Leaving DKA untreated can lead to irreparable damage and even death. It is important to seek medical care as soon as you suspect you are having a problem. 2 Stay in the hospital. Ketoacidosis is usually treated in the hospital. You may be admitted to a regular room or treated in ICU depending on the severity of your symptoms. During the first hours you are there, the doctors will work on getting your fluids and electrolytes balanced, then they will focus on other symptoms. Most of the time, patients remain in the hospital until they are ready to return to their normal insulin regimen.[4] The doctor will monitor you for any other conditions that may cause complications, like infection, heart attack, brain problems, sepsis, or blood clots in deep veins. 3 Increase your fluid intake. One of the first things that will be done to treat your diabetic ketoacidosis is to replace fluids. This can be in the hospital, a doctor’s office, or home. If you are receiving medical care, they will give you an IV. At home, you can drink fluids by mouth.[6] Fluids are lost through frequent urination and must be replaced. Replacing fluids helps balance out the sugar levels in your blood. 4 Replace your electrolytes. Electrolytes, such as sodium, potassium, and chloride, are important to keep your body functioning p Continue reading >>
What You Should Know About Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>
Ketosis
Not to be confused with Ketoacidosis. Ketosis is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides energy. Ketosis is a result of metabolizing fat to provide energy. Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate,[4] and the levels of ketone bodies are regulated mainly by insulin and glucagon.[5] Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder. Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical intervention for various conditions, such as intractable epilepsy, and the various types of diabetes.[6] In glycolysis, higher levels of insulin promote storage of body fat and block release of fat from adipose tissues, while in ketosis, fat reserves are readily released and consumed.[5][7] For this reason, ketosis is sometimes referred to as the body's "fat burning" mode.[8] Ketosis and ketoacidosis are similar, but ketoacidosis is an acute life-threatening state requiring prompt medical intervention while ketosis can be physiological. However, there are situations (such as treatment-resistant Continue reading >>
Diabetic Ketoacidosis
Initial Evaluation Initial evaluation of patients with DKA includes diagnosis and treatment of precipitating factors (Table 14–18). The most common precipitating factor is infection, followed by noncompliance with insulin therapy.3 While insulin pump therapy has been implicated as a risk factor for DKA in the past, most recent studies show that with proper education and practice using the pump, the frequency of DKA is the same for patients on pump and injection therapy.19 Common causes by frequency Other causes Selected drugs that may contribute to diabetic ketoacidosis Infection, particularly pneumonia, urinary tract infection, and sepsis4 Inadequate insulin treatment or noncompliance4 New-onset diabetes4 Cardiovascular disease, particularly myocardial infarction5 Acanthosis nigricans6 Acromegaly7 Arterial thrombosis, including mesenteric and iliac5 Cerebrovascular accident5 Hemochromatosis8 Hyperthyroidism9 Pancreatitis10 Pregnancy11 Atypical antipsychotic agents12 Corticosteroids13 FK50614 Glucagon15 Interferon16 Sympathomimetic agents including albuterol (Ventolin), dopamine (Intropin), dobutamine (Dobutrex), terbutaline (Bricanyl),17 and ritodrine (Yutopar)18 DIFFERENTIAL DIAGNOSIS Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap. The primary differential diagnosis for hyperglycemia is hyperosmolar hyperglycemic state (Table 23,20), which is discussed in the Stoner article21 on page 1723 of this issue. Common problems that produce ketosis include alcoholism and starvation. Metabolic states in which acidosis is predominant include lactic acidosis and ingestion of drugs such as salicylates and methanol. Abdominal pain may be a symptom of ketoacidosis or part of the inci Continue reading >>
Diabetes With Ketone Bodies In Dogs
Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is an abnormal form of ketosis. It a danger mostly to people with type 1 diabetes, but it can also happen to people with type 2 diabetes under certain circumstances. DKA is is the most common cause of death for people with type 1 diabetes mellitus (T1DM), and the condition is especially dangerous for children with T1DM. Many children end up in the hospital with DKA before receiving a diagnosis of T1DM. The problem begins in the pancreas. The human pancreas secretes insulin, a hormone that helps the body manage blood sugar and fat storage. Without insulin, the body cannot use glucose for fuel in the cells, and fat cannot be stored in the fat cells. This is why one of the symptoms of Type 1 diabetes is unexplained weight loss. Type 1 diabetics develop pancreatic damage which results in a complete lack of insulin production, and as a consequence, their fat cells have no insulin message telling them to keep the fatty acids stored. Without that message from insulin, vast quantities of fatty acids flow out of the fat cells and are broken down in the liver into acetate, acetoacetic acid and D-3-hydroxybutyric acid (ketones). The danger of this kind of ketoacidosis is in the amounts of the ketone bodies being released. Because ketone bodies are slightly acidic in nature, and so many are released at once, they build up in the bloodstream. The sheer volume quickly overwhelms the delicate acid-base buffering system of the blood, and the blood pH drops to become more acidic than normal.The low blood pH (acidosis) is the condition which is dangerous, not the ketones themselves. Ketoacidosis symptoms include: Fruity breath Nausea and vomiting Hyperventilation (deep, rapid breathing) Dehydration Low blood pressure Diabetics can develop this condition if the Continue reading >>
A Keto Diet For Beginners
A keto or ketogenic diet is a very low-carb diet, which turns the body into a fat-burning machine. It has many proven benefits for weight loss, health and performance, as millions of people have experienced already. 1 Here you’ll learn how to eat a keto diet based on real foods. You’ll find visual guides, recipes, meal plans and a simple 2-week get started program, all you need to succeed on keto. Get even more, custom meal plans, ask the experts and low-carb TV, with a free trial. 1. Introduction: What is ketosis? The “keto” in a ketogenic diet comes from the fact that it makes the body produce small fuel molecules called “ketones”. 2 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 quickly broken down into blood sugar) and only moderate amounts of protein (excess protein can also be converted to blood sugar). Ketones are produced in the liver, from fat. They are then used as fuel throughout the body, including the brain. The brain is a hungry organ that consumes lots of energy every day, 3 and it can’t run on fat directly. It can only run on glucose… or ketones. 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 obviously great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. When the body produces ketones, it’s said to be in ketosis. The fastest way to get there is by fasting – not eating anything – but nobody can fast forever. A keto diet, on the other hand, can be eaten indefinite Continue reading >>
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 >>
