Ketones — The 6 Must-knows
WRITTEN BY: Kyla Schmieg, BSN, RN Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and Type 1 Diabetic, working on the same unit she was diagnosed at 26 years ago. 1 – What are ketones? Ketones are chemicals that build up when your body starts to burn fat for energy. The most common cause of ketones in diabetics is insulin deficiency. Without enough insulin, glucose builds up in the blood stream and can’t enter cells. The cells then burn fat instead of glucose. This results in ketones forming in the blood and eventually spilling into urine. 2 – Why can ketones be dangerous? Having ketones can indicate that your body needs more insulin. (Always monitor your blood sugar levels to know how much insulin you need.) If you have a build up of ketones, this can lead to Diabetic Ketoacidosis (DKA). Signs of DKA include moderate or large ketones, nausea, vomiting, abdominal pain, fruity or acetone (think nail polish remover) breath, rapid breathing, flushed skin, and lack of energy. If left untreated, it can lead to a serious and life-threatening diabetic coma or death. High levels of ketones are toxic to the body and if you’re experiencing these, you should seek out medical attention. 3 – When should you check for ketones? You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold. 4 – Can you get ketones with a high blood sugar? Ketones typically accompany high blood sugar. They indicate that your body needs more insulin. Most often if your body needs more insulin, it means you probably have a high blood sugar. Also, when an illness is present, your body releases hormones in response to the stress. These hormones 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 >>
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 >>
For The Love Of Exogenous Ketones!
You read that correctly. I love ketones and I am actively pursuing ways to increase my bodies ability to produce them through the use of exogenous ketone supplements. Ketones are a dirty word in the world of diabetes because of the confusion surrounding their appearance as the harbinger of doom through DKA (diabetic ketoacidosis). Unfortunately many healthcare providers actively discourage their diabetic patients from attempting to achieve nutritional ketosis because they don’t fully understand the difference between nutritional ketosis and DKA. That difference is NOT the focus of this post, other than to establish the fact that there IS a difference. It’s important to note that the means of detecting DKA is typically the presence of ketones in the blood. Adding them through exogenous supplementation or nutritional ketosis is useful (I would even argue beneficial), but not without some risk. In case of insulin deficiency (bad pump site, occlusion, skipped dose etc) while in ketosis one would be without the means to clearly identify DKA. You’d only be able to guess based on blood glucose level to infer how insulin deficient you are. The risk can be mitigated through vigilance and attention to insulin dosing but shouldn’t be taken lightly. I’ve recently started using exogenous ketones to help put me into nutritional ketosis more readily and I wanted to report the initial findings since I’ve been asked about them so many times. Up till this point I didn’t feel compelled to spend the time and money on exogenous ketone supplements–which are not cheap! I took the plunge and got some delicious, chocolate-flavored betahydroxybutyrate or (BHB) for short. I am not going to attempt to get into the science behind the impacts of BHB on my blood sugar, energy and meta Continue reading >>
Diabetic Ketoacidosis (dka)
Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) occurs when the body does not have enough insulin. Insulin is what breaks down sugar into energy. When insulin is not present to break down sugars, our body begins to break down fat. Fat break down produces ketones which spill into the urine and cause glucose build up in the blood, thus acidifying the body. Because sugar is not entering into our body’s cells for energy breakdown, the sugar is being processed by the kidneys and excreted through the urine; as a result, we become dehydrated and our blood becomes even more acidic. This leads to sickness and hospitalization if not treated. If a person’s blood sugar is over 240, they should start checking their blood for ketones. If you have diabetes, or love someone who does, being aware of warning signs of diabetic ketoacidosis (DKA) can help save a life. Early Symptoms of DKA: High blood glucose level, usually > 300 High volume to ketones present in blood or urine Frequent urination or thirst that lasts for a day or more Dry skin and mouth Rapid shallow breathing Abdominal pain (especially in children) Muscle stiffness or aches Flushed face As DKA Worsens: Decreases alertness, confusion – brain is dehydrating Deep, labored, and gasping breathing Headache Breath that smells fruity or like fingernail polish remover Nausea and/or vomiting Abdomen may be tender and hurt if touched Decreased consciousness, coma, death If you think you might have DKA, test for ketones. If ketones are present, call your health care provider right away. To treat high blood sugar, hydrate with water or sugar free, caffeine free drinks. Sugar free popsicles and snacks are also good alternatives. Always call the doctor if vomiting goes on for more than two hours. Symptoms can go from mild Continue reading >>
Optimal Ketone And Blood Sugar Levels For Ketosis
A low carb helps reduce blood sugars and insulin levels and helps with the management of many of the diseases of modern civilisation (e.g. diabetes, heart disease, stroke, cancer, Parkinson’s and Alzheimer’s). We become insulin resistant when our body fat can’t store any more energy. Excess energy is then stored in the liver, pancreas, heart, brain and other organs that are more insulin sensitive. We also see increased levels of energy in our blood in the form of glucose, fat and elevated ketone. Endogenous ketosis occurs when we eat less food than we need. Our insulin and blood sugar levels decrease and ketones rise to supply the energy we need. Exogenous ketosis occurs when we eat lots fat and/or take exogenous ketones. Blood ketones rise, but our insulin levels will also rise because we have an excess of energy coming from our diet. Most of the good things associated with ketosis occur due to endogenous ketosis. Most people following a ketogenic diet over the long term have ketone values lower than what some people consider to be “optimal ketosis”. If your goal is blood sugar control, longevity or weight loss then endogenous ketosis with lower blood sugars and lower ketones is likely a better place to be than chasing higher blood ketones. I have seen a lot of interest and confusion recently from people following a ketogenic about ideal ketone and blood sugar levels. In an effort to try to clear this up, this article reviews blood ketone (BHB), breath ketone (acetone) and blood sugar data from a large number of people who are following a low carb or ketogenic diet to understand what “normal” and “optimal” look like. Many people initiate a low carb diet to manage their blood glucose levels, insulin resistance or diabetes. As shown in the chart below, Continue reading >>
4: Fasting For Keto-adaptation, High Blood Ketones, Elevated And Low Blood Sugar, No Weight Loss, Slowing Fat Metabolism
Veteran health podcaster, blogger, international speaker, and bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” teams up with Toronto, Ontario Canada-based nephrologist Dr. Jason Fung from IntensiveDietaryManagement.com and Dr. Fung’s Clinical Director at his Intensive Dietary Management Program clinic Megan Ramos on this podcast dedicated to answering YOUR questions about intermittent, alternate day, and extended fasting. Jimmy and Dr. Fung are the coauthors of the 2016 international bestseller The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting and, along with Megan, are happy to provide this podcast as an additional resource for anyone curious about going on a fast to improve their health. We love hearing from our listeners with new questions–send an email to Jimmy at [email protected] And if you’re not already subscribed to the podcast on iTunes, then you can do that and leave a review HERE. Listen in today as Jimmy and Megan answer your questions about all things fasting in Episode 4. FREE N=1 TRACKING TOOL AT HEADS UP HEALTH – Whether you should fast when you are sick HOT TOPIC: Can you use fasting as a way to get keto-adapted faster? Can you get keto-adapted faster with fasting? And why do you get angry on the second day of fasting? What do you do about that? Mary KEY QUOTE: “We tell patients not to stop their fast on the third day because that’s usually the hardest, but once you are keto-adapted, you can fast for as many days as you want, usually without implication, so on the third day of my fast I don’t experience any third day hump.”- Megan Ramos 1. Can blood ketones go too high while you are fasting? Hey guys, I’m 71 years old with a low BMI and no medical or h Continue reading >>
Caution: Don’t Get Caught With Ketones
Ketoacidosis is an extremely serious diabetic complication that can lead to coma and even death. Unfortunately it is also fairly common. The good news, however, is that with proper care and an eye towards prevention, this costly and dangerous complication can be avoided. What Is Ketoacidosis? When there isn't enough insulin present for the metabolism of glucose, or when insufficient food has been eaten to satisfy energy requirements, the body burns fat for energy. Ketones are toxic, acidic byproducts of this process. Ketones are normally processed by the kidneys and excreted in the urine. But when more ketones are produced than the kidneys can handle, they can build up in the blood and lead to a dangerous condition known as diabetic ketoacidosis (DKA). Ketoacidosis raises the acidity of the body, which leads to "a cascade of problems throwing off a number a parameters in the body," says Cindy Onufer, RN, MA, CDE, the diabetes research and clinical care coordinator at Oregon Health Sciences University. Ketoacidosis rarely occurs in people with type 2 diabetes, who usually do not suffer from insufficiency of insulin, but is of great concern to those with type 1 diabetes. In fact, ketoacidosis is the number one cause of hospitalization for children with known diabetes in the United States. However, these hospitalizations are completely preventable if a urine ketone test is done and a care provider is called when indicated, says H. Peter Chase, MD, with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado. Timely testing and prevention are of utmost importance as the condition can cause coma and death if proper treatment is not administered quickly. Higher ketone levels are a warning sign that your diabetes is out of control or that you may be in danger of ke Continue reading >>
How To Easily Track Your Glucose Ketone Index (gki) On Your Ketogenic Diet
Tracking ketone levels is a large part of success on the ketogenic diet. It helps you know how far you are into ketosis and where we might need to make changes. But did you know that there’s an even better way to step it up a notch? The glucose ketone index is a simple calculation that allows you to find out how ketosis works best for you individually. Without it, you could be in full, high-level ketosis yet still not getting the full benefits. In this post, we’ll be looking at how to easily track your glucose ketone index for different aspects of health along with your ketogenic diet. Basics of the Glucose Ketone Index Here’s what you need to know about the glucose ketone index (GKI): Researchers have used the index in studies on the ketogenic diet, fasting, and more. Additionally, it has been used for tracking changes and progress regarding weight loss, athletic performance, management of metabolic diseases like type 2 diabetes, and even cancer treatment. Now that we’ve covered the basics of what the GKI does, let’s talk about how you can use tracking it to your advantage. Tracking Your Glucose Ketone Index What’s so special about the glucose ketone index is that it lets you track both glucose and ketones at the same time, taking into account how they work together. It’s a way to know your optimal state for addressing all sorts of health conditions. Tracking this number benefits you over simply measuring ketone levels. That’s because even if you’re deeply in ketosis, you could still have high blood glucose levels that throw things off and affect your health. Essentially, it gives you a more full picture of your metabolic health. The numbers you can expect to target depend on your intentions for being in ketosis. Is your goal weight loss, better overa Continue reading >>
What Are Ketones And Their Tests?
A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>
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- Are ketones dangerous?
Ketotic hypoglycemia is a medical term used in two ways: (1) broadly, to refer to any circumstance in which low blood glucose is accompanied by ketosis, and (2) in a much more restrictive way to refer to recurrent episodes of hypoglycemic symptoms with ketosis and, often, vomiting, in young children. The first usage refers to a pair of metabolic states (hypoglycemia plus ketosis) that can have many causes, while the second usage refers to a specific "disease" called ketotic hypoglycemia. Hypoglycemia with ketosis: the broad sense There are hundreds of causes of hypoglycemia. Normally, the defensive, physiological response to a falling blood glucose is reduction of insulin secretion to undetectable levels, and release of glucagon, adrenaline, and other counterregulatory hormones. This shift of hormones initiates glycogenolysis and gluconeogenesis in the liver, and lipolysis in adipose tissue. Lipids are metabolized to triglycerides, in turn to fatty acids, which are transformed in the mitochondria of liver and kidney cells to the ketone bodies— acetoacetate, beta-hydroxybutyrate, and acetone. Ketones can be used by the brain as an alternate fuel when glucose is scarce. A high level of ketones in the blood, ketosis, is thus a normal response to hypoglycemia in healthy people of all ages. The presence or absence of ketosis is therefore an important clue to the cause of hypoglycemia in an individual patient. Absence of ketosis ("nonketotic hypoglycemia") most often indicates excessive insulin as the cause of the hypoglycemia. Less commonly, it may indicate a fatty acid oxidation disorder. Ketotic hypoglycemia in Glycogen storage disease Some of the subtypes of Glycogen storage disease show ketotic hypoglycemia after fasting periods. Especially Glycogen storage Continue reading >>
Ketones And Low Blood Sugar....
Ketones are totally normal in the human body. It's just when you get too many of them it gets dangerous. I have the same meter and usually test around .1 or .2 and it's fine. Read the instructions for your strips. I think it says you're in ketosis at .8 and above. Trust me, real ketosis will make you feel really sick and usually it comes with a blood sugar of 300 and above. You go into ketosis when you have little or no insulin. Happens when you forget your Lantus/Levemir or when your pump malfunctions. In case you are type 2, ketosis normally shouldn't be of concern anyway. Thank you for finding the brochure. I am printing it as we speak and I will keep it with my meter and my other important papers. For some strange reason I seem to have lost the instructions with my strips. In the beginning when I was first diagnosed I had a blood sugar of 450 (25) and I really did not feel well at all. Now quite a number of years later I was curious to see if a person registers ketones when your blood sugar is low. Then when I realized that maybe it also had something to do with low carbing - I was both concerned and curious. There are 2 ketone-related conditions, one (mostly) good and one bad. Ketoacidosis is the bad one, caused by insufficient insulin and ultra-high blood sugar spikes. Ketosis is the good one, caused by low-carb diet and exercise. Ketosis promotes weight loss. I'm glad to know I'm not doing something harmful. My GP has never explained these things to me. I need all the help I can get to lose a little weight btw - Shalynne - could you remove post #4 as I don't think there should be two of the same post - not sure what happened because for just a moment my computer screen froze, then I had to reboot. Continue reading >>
Large Ketones - Low Blood Sugar!??
High Ketones But Low Blood Sugar
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have been off work ill for the last week with the wonderful winter vomiting virus. Im pretty much ok from it now. BEcuase ive not been well I have followed the rules and tested a bit more than usual, and my readings have been low as expected as ive only really just got my apetite back. What i didnt know i should be doing was checking urine for ketones. Historically ive not got more than a + when bs has been 15+. Now that i have been testing, im getting readings of ++++, a super dark browney purple colour, but my bs is only 9. bumping this in the hopes someone can help. Because you haven't been eating you are burning fat for energy and the by-product is the ketones. You can stop this if you can keep some carbs down and give yourself insulin. You are Type 1 I gather. My son's doctor wasn't overly concerned about the ketones when he last had the vomits but I certainly kept an eye on the amount over the course of the illness. You do have to manage ketones and blood sugar while sick but it isn't always easy. I have a blood ketone tester as urine ones aren't really very acurate. Try and keep some fluid down by sipping small amounts of water often. You can also get yourself some hydralyte or gastrolyte. Continue reading >>
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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 >>