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 >>
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 >>
The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able 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 >>
#12: Hypoglycemia – Can Ketones Help Fuel The Brain?
The Diabetes Control and Complications Trial It is estimated that iatrogenic hypoglycemia is responsible for 6-10% of deaths in persons with type 1 diabetes (T1D). The Diabetes Control and Complications Trial (DCCT) completed in 1993 showed that “Intensive (insulin) therapy effectively delays the onset of and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with insulin-dependent diabetes mellitus (IDDM).” Consuming a diet high in carbohydrates as was the practice in 1993 (and for most part in 2015) combined with high doses of insulin leads to both hyperglycemia and hypoglycemia. At the beginning of the DCCT, mean insulin doses were 0.62-0.72 U/kg/day. The insulin doses were increased (but not reported) in the intensive insulin therapy group and this increase resulted in both weight gain (with a 33% increase in the mean adjusted risk of becoming overweight) and a three-fold increase in severe hypoglycemia (“severe” meant requiring assistance including seizure or coma). In addition, the glycemic goal of the intensive insulin therapy group was HbA1c < 6.05%, but less than 5% maintained the goal and the mean HbA1c actually achieved was ≈7% (presumably to avoid hypoglycemia). The DCCT clearly showed that improving glycemic control (lowering HbA1c) reduced the incidence and progression of diabetic complications. Another conclusion still applies today, “we recommend that most patients with IDDM be treated with closely monitored intensive regimens, with the goal of maintaining their glycemic status as close to the normal range as safely possible. Because of the risk of hypoglycemia, intensive insulin therapy should be implemented with caution, especially in patients with repeated severe hypoglycemia.” Asymptomatic Hypoglycemi Continue reading >>
Diabetes With Ketone Bodies In Dogs
Diabetes Mellitus with Ketoacidosis in Dogs Diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. The term “ketoacidosis,” meanwhile, refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies”. 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. This condition typically affects older dogs as well as females. In addition, miniature poodles and dachshunds are predisposed to diabetes with ketoacidosis. 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 dog'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 dog’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 (azo Continue reading >>
Surviving A Stomach Virus With Type 1 Diabetes
Taking care of someone with diabetes when they’re sick is tough; taking care of yourself when you’re sick and have diabetes is tougher (and not to mention super freaking scary). For those of us living with type 1 diabetes something as small as a stomach virus can quickly become serious if you make the wrong move. Knowing what to do and when to do it is more complicated than you might think. Why is that? Because everyone’s body reacts to a cold or virus differently (heck my own body acts differently every time!) so you need to be prepared for the unpredictability that is stomach virus blood sugar…and since you’re already a T1D you should be a pro at unpredictability. How Illness Affects Blood Sugar The body perceives illness as stress, and when your body is stressed it releases hormones such as cortisol and epinephrine (adrenaline), which raises your blood sugar levels. However, sometimes the illness can lower your blood sugar because you aren’t eating (and have background insulin running) or can’t keep food down (and have just bolused for a meal). So My Blood Sugar Goes A Little Crazy For A Day Or Two, Big Flippin’ Deal Most of the time it really is no big deal, however, being stuck up shits creek (literally) and not having a plan in place is a big flippin’ deal. There are two ways an illness can go really wrong really fast when you’re a type 1 diabetic DKA – Diabetic Ketoacidosis (which is much different than nutritional ketosis – but that’s a post for another time) is when there is a toxic amount of ketones in your blood. So much so that your blood becomes acidic to the point of being fatal. The acidity becomes even more potent when you’re dehydrated, which will happen if you are losing it from both ends and can’t keep anything down (or i Continue reading >>
Diabetic Ketoacidosis - Symptoms
A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>
Diabetes Dictionary (glossary)
Print Blood glucose (BG) or blood sugar level: The amount of glucose (sugar) found in the blood. Either term can be used. In Canada, blood sugar levels are measured as mmol/L. Blood glucose monitor (or glucometer): A medical device used to check blood glucose level. A drop of blood is placed on a test strip, which is inserted into a hand-held meter. Students with diabetes are encouraged to keep their meter with them at all times. Carbohydrate (CHO or carb): Sugars, fibres or starches found in many processed and unprocessed foods. Examples of carb-containing foods include breads, cereals, beans, pasta, fruits, milk, potatoes, and more. Carbohydrates provide the body with glucose (sugar), and are its main source of energy. Eating carbs raises blood sugar level, but some carbs work more quickly than others (see Fast-acting sugar). Celiac disease: A medical condition that causes an immune reaction to eating gluten, which is a protein found in wheat, rye and barley. It causes damage to the intestines and symptoms like stomach pain, bloating, and diarrhea. People with celiac disease must follow a gluten-free diet. Up to 10% of people with type 1 diabetes also have celiac disease. Continuous Glucose Monitor (CGM, sensor): A device that provides a blood glucose reading every 5 minutes through a small sensor inserted under the skin. Correction factor (CF) (or insulin sensitivity factor (ISF)): Unique to each person, it is the amount that 1 unit of fast-acting insulin will lower a person’s blood sugar. People with diabetes use correction factors to adjust insulin doses for the blood sugar level at the time of the dose. Diabetes Kit (also called Hypokit, Safe kit, Emergency Kit): A sturdy container, such as a plastic box, with all the supplies needed to treat high or low blood s Continue reading >>
(rare Causes). Hypoglycemia And Ketotic Hypoglycaemia, January 2016
Information for parents and carers Hypoglycaemia (low blood sugar) and ketotic hypoglycaemia What is hypoglycaemia? Hypoglycemia is having a blood glucose (also known as blood sugar) level that is too low to provide energy for the body's cells. What is glucose? Glucose is a sugar that is made from the breakdown of carbohydrates found in foods. It is the main source of fuel for the body (including the brain). It may be stored in the liver and muscles for later use, but spare glucose is converted to fat. The level of glucose in the blood is controlled by complex hormone and energy pathways. What is a healthy range of blood glucose? The normal range of blood glucose throughout the day and night is around 3.5 â€“ 6 mmols/litre. However, this varies according to a number of factors; your childâ€™s doctor will talk with you about what should be a normal range for him or her. Why is hypoglycemia a concern? The brain depends on glucose, and too little can affect its ability to function. Severe or very prolonged hypoglycemia could result in fits or serious brain injury. We think your child may be at risk of low blood sugar and you will have been given some advice and treatment to prevent this problem. Causes in young children Single episodes: ï€ Sickness and diarrhoea, or another illness that may cause them to not eat enough. ï€ Fasting for a prolonged period of time. ï€ Prolonged exercise with lack of food. Recurrent episodes: ï€ Ketotic hypoglycaemia. ï€ Medications your child may be taking. ï€ Congenital (present at birth) error in energy metabolism or unusual hormone problem Hypoglycemia and ketotic hypoglycaemia What is ketotic hypoglycaemia? A common reason for recurrent episodes of low blood sugar in young children is ketotic hypoglycaemia, whi Continue reading >>
What Is The Ph Of The Blood In A Diabetic Patient When His Glucose Levels Are Appropriate?
Diabetes causes your body's pH levels to become more acidic and develop a condition called ketoacidosis, the American Diabetes Association explains. Your body's pH level refers to the acidity or alkalinity of the fluids in your body. Diabetes impairs your body's ability to properly utilize the glucose in your blood. Instead, your body is forced to convert fat into energy through a process that develops into ketoacidosis. Diagnosing ketoacidosis involves testing blood for the presence of ketones, the University of Maryland Medical Center explains. There are two main types of diabetes. Type 1 diabetes is congenital, and its symptoms appear as early as childhood, MayoClinic.com explains. Type 1 diabetes is characterized by your body's inability to produce insulin, the hormone needed for cells to metabolize glucose into energy. Type 2 diabetes is essentially defined by acquired insulin resistance that usually manifests in adulthood. Both types of diabetes cause increased thirst, frequent urination, unexplained weight loss, hypertension and ketoacidosis. Left untreated, both types of diabetes lead to complications that damage your cardiovascular system, kidneys and nerves due to the accumulated glucose in your blood. Complications due to diabetes such as ketoacidosis are fatal if not treated. Ketones are the acidic byproducts of fat breakdown that accumulate when your body uses fat instead of glucose as a source of fuel, MedlinePlus, a service of the National Institutes of Health, explains. As your ketone levels increase, your body becomes more acidic. Ketones are present in both types of diabetes but are generally more typical of type 1 diabetes. Ketones are also sometimes present in urine. Acetone and acetoacetic acid are examples of ketones. Ketoacidosis does not happen o Continue reading >>
Diabetes: Low Blood Sugar And High Blood Sugar
Facts about low blood sugar and high blood sugar: If your child does not have diabetes, his/her body will keep the blood sugar level steady. When your child eats or exercises, the blood sugar will stay at a steady level because insulin is working properly. If your child has diabetes, "good control" means keeping his/her blood sugar level as close as possible to the ideal range. Problems can result from too high (high blood sugar) or too low (low blood sugar) blood sugar levels. If high blood sugar becomes severe, it is called Diabetes Ketoacidosis (DKA). How can you tell which reaction is taking place? Low Blood Sugar (Hypoglycemia) High Blood Sugar (Hyperglycemia) Causes Too much insulin Too little food Too much exercise without extra food Skipping meals Not eating on time Illness Too little insulin or forgetting to take insulin Too much food Infection, ililness, fever Emotional stress Onset Rapid If your child receives fast-acting insulin, Humalog or Novolog, low blood sugar may occur 1/2-2 hours after dose is given. If your child receives regular insluin (clear): low blood sugar may occur 1-3 hours after dose is given If you child receives NPH or 70/30 (cloudy): low blood sugar may have a slower onset; 6-8 hours after dose is given Slow, hours to days Symptoms (How your child may feel or act) Dizzy, shaky Hungry Pale, sweaty Headache Slurred speech Poor balance Seeing double (two of everything) Tired, weak Treatment Use one of these fast-acting sugars (15 gram fast-acting carbohydrate) followed by a snack or meal: - Sugar cubes (2) - Orange juice ( ½ cup) - Regular soft drink ( 1cup) - Cake decorating gel ( ½ small tube) - Raisins (handful) If your child does not feel better in 15 minutes, treat again If severe, give Glucagon and call 911 Take insulin, if omitted T Continue reading >>
Diabetes: Sending Your Child To School
www.CardioSmart.org Managing diabetes can be hard, especially for children and teenagers. Having diabetes may cause your child to feel different or embarrassed at school, especially when checking blood sugar or taking shots. As your child faces these challenges, be as helpful and supportive as you can. Remind your child that diabetes care is very important. It may help for your child to explain to classmates what diabetes is and what shots and meters are for. Having a good treatment plan can make things easier. Keep your child's teachers, coaches, and other school staff informed about how to give diabetes care and manage blood sugar emergencies. Youmaywant to schedule a yearly meeting with the school staff. Managing diabetes at school Your doctor can help you make a written treatment plan for managing diabetes. Give this plan to your child's teachers and coaches and other school staff who work with your child. The plan should include: â€¢ When to check blood sugar and give insulin. Include your child's target blood sugar range and dose amounts for insulin. â€¢ Your child's usual symptoms of low and high blood sugar. â€¢ What to do for high and low blood sugar emergencies, and when to contact you. â€¢ When to give meals and snacks, and what foods are best. Include instructions for parties and field trips. â€¢ Instructions for testing for ketones, including what to do if ketones are present. â€¢ Emergency contact numbers, including your child's main caregivers and doctor. For older children who take insulin to school, check whether the school has rules about students carrying their own medicines, needles, and blood sugar meters. Many schools require that students get special permission or that supplies be kept at the school. Your child should have Continue reading >>
What Is Diabetes In Pregnancy?
Having diabetes means that there is too much sugar (glucose) in your blood. Some women have diabetes before they get pregnant. Others start having it during pregnancy. Diabetes that starts during pregnancy is called gestational diabetes. If you had diabetes before you became pregnant, it may get harder for you to control your sugar levels during pregnancy. Pregnancy can make both high and low blood sugar levels happen more often. It can make diabetic eye, kidney, heart, blood vessel, and nerve problems worse. You may need to change your insulin dosage. If you were not using insulin before the pregnancy, you may need to use it while you are pregnant. If you develop diabetes during pregnancy, you may need to start a special diet. You may need to have insulin shots or take a pill to help control your blood sugar. If diabetes is not treated well before and during pregnancy, and your sugars are poorly controlled, these problems might occur: The high sugar levels in your blood might cause the baby to get too big before birth. Very large babies tend to have more problems. Babies who are very large or have other problems may need to be delivered by C section. If delivered vaginally, a big baby is slightly more likely to have an injury at the time of delivery. The baby might have birth defects, such as problems with the heart, kidney, spine, or brain. Some of these problems may be life threatening. You might have high blood pressure during the pregnancy, which can cause problems for both you and the baby. You may develop ketones in your blood and urine when you have very high blood sugar. This can cause a very serious, life-threatening condition called diabetic ketoacidosis. You might go into labor early. The baby might need to be delivered early. After delivery the baby’s blo Continue reading >>
Ketones And Exercise – What You Need To Know
A researcher on diabetes and exercise describes why exercise elevates risk of DKA for people with Type 1 diabetes. In a new set of guidelines for Type 1 diabetes and exercise, I and my fellow researchers warn that people with Type 1 diabetes need to monitor for elevated levels of ketones during exercise. If you have Type 1 and exercise regularly, testing for ketones could save your life. Ketones develop in our bodies when we mobilize fat as fuel. Fat is an important energy source that is used by the body at rest and during exercise. Ketones are a general term in medicine used to describe the three main ketone bodies that the liver produces – acetoacetate, beta-hydroxybutyrate, and acetone. Read “Too Many with Type 1 Don’t Test for Ketones.” sponsor Ketone bodies help fuel the brain and skeletal muscle during times of prolonged fasting or starvation, so in a way ketones are very important for survival. We actually have enough stored fat to generate energy for days, but this can cause a number of metabolic problems, the most important of which is ketoacidosis. In Type 1 diabetes, ketone levels can rise even without starvation, if insulin levels drop too much and levels of other hormones like glucagon and catecholamines rise. This rise in ketone levels in diabetes can cause a life-threatening condition called diabetic ketoacidosis (DKA). Read “How DKA Happens and What to Do About it.” The symptoms of ketoacidosis include: A lack of energy, weakness, and fatigue Nausea and vomiting, stomach pain, decreased appetite Rapid weight loss Decreased perspiration, foul or fruity breath Altered consciousness, mild disorientation or confusion Coma sponsor The reasons for developing high ketone levels in Type 1 diabetes include: Missed insulin injections Failure of insulin Continue reading >>