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Nutritional Ketoacidosis

* What Are Ketones And Nutritional Ketosis?

* What Are Ketones And Nutritional Ketosis?

There is a lot of confusion about the term ketosis among medical professionals as well as laypeople. It is important to understand when and why nutritional ketosis occurs, and why it should not be confused with the metabolic disorder we call ketoacidosis. Ketosis is a metabolic state where the liver produces small organic molecules called ketone bodies. Most cells in the body can use ketone bodies as their source of energy. When there is limited supply of external energy sources, such as during prolonged fasting or carbohydrate restriction, ketone bodies can provide energy for most organs. Ketosis can be regarded as a normal, adaptive physiologic response that is essential for life, enabling us to survive periods of famine. Nutritional ketosis should not be confused with ketoacidosis, a metabolic condition where the blood becomes acidic as a result of the accumulation of ketone bodies. Ketoacidosis can have serious consequences and may need urgent medical treatment. The most common forms are diabetic ketoacidosis and alcoholic ketoacidosis. A ketogenic diet requires carbohydrate and protein restriction, with 50 to 80 percent of calories coming from fats; this forces your body to shift toward using ketones as its primary fuel source, instead of glucose. In the past the only way to achieve this was to restrict the carbohydrate foods that your body uses for fuel. This would force your body to go from using glucose as it's primary source of fuel to using ketones as the primary source for energy. When your body is in nutritional ketosis, your body is using fat as its source of energy. Today we can also achieve this state in our bodies with Keto//OS supplementation. * How do I know if I am in a Nutritional Ketosis state? There are significant differences between Keto//OS and Continue reading >>

Ketogenic Diet: 25 Proven Benefits And How To Know If It’s Right For You

Ketogenic Diet: 25 Proven Benefits And How To Know If It’s Right For You

The ketogenic diet has been touted for its many health benefits such as weight loss, cognitive function, neurodegenerative diseases, and cancer. In this post, we cover: Different ways to get into ketosis Physiology and pathways that are changed when you are in ketosis, which explains how the ketogenic diet derives its benefits Genetic factors that may affect the safety and effectiveness of ketosis 17 Health conditions that may be helped by the ketogenic diet Negative effects of ketosis and how to mitigate them Ketogenic Diets Improve Cognitive Function and Brain Health Ketogenic Diet as a Cancer Treatment Ketogenic diets are defined by a low carbohydrate (typically under 50 grams/day) and high fat intake, leading to an elevation of free fatty acids and ketone bodies in the blood (R). The first ketogenic diets in the medical literature are noted in publications in the 1920s, although wider popularity and increased research was not seen in medical literature until the 1960s (R). Variations of the diets have remained popular for the past 20-30 years, with proponents claiming that the diets boost weight loss and energy while offering protection from certain metabolic diseases (R). A ketogenic diet and fasting affect the body similarly. Both deplete the body’s glucose reserves, so the body starts turning fatty acids into ketones (R). When the body doesn’t have enough carbohydrates from food, it burns fat by producing ketones or ketone bodies (R, R). In non-diabetics, ketosis can be achieved in 3 ways, i.e. Fasting or severe caloric restriction (R) Prolonged physical exercise in fasted state, depending on intensity and duration (R, R2) Nutritional ketosis, i.e. by consuming a very low carbohydrate diet Supplementation, such as by supplementing with medium chain triglyceri Continue reading >>

What Is Ketosis?

What Is Ketosis?

"Ketosis" is a word you'll probably see when you're looking for information on diabetes or weight loss. Is it a good thing or a bad thing? That depends. Ketosis is a normal metabolic process, something your body does to keep working. When it doesn't have enough carbohydrates from food for your cells to burn for energy, it burns fat instead. As part of this process, it makes ketones. If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin. Ketosis can become dangerous when ketones build up. High levels lead to dehydration and change the chemical balance of your blood. Ketosis is a popular weight loss strategy. Low-carb eating plans include the first part of the Atkins diet and the Paleo diet, which stress proteins for fueling your body. In addition to helping you burn fat, ketosis can make you feel less hungry. It also helps you maintain muscle. For healthy people who don't have diabetes and aren't pregnant, ketosis usually kicks in after 3 or 4 days of eating less than 50 grams of carbohydrates per day. That's about 3 slices of bread, a cup of low-fat fruit yogurt, or two small bananas. You can start ketosis by fasting, too. Doctors may put children who have epilepsy on a ketogenic diet, a special high-fat, very low-carb and protein plan, because it might help prevent seizures. Adults with epilepsy sometimes eat modified Atkins diets. Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show sp Continue reading >>

[severe Ketoacidosis In Breastfeeding Woman With Low Energy And Carbohydrate Intake].

[severe Ketoacidosis In Breastfeeding Woman With Low Energy And Carbohydrate Intake].

Abstract Ketoacidosis is a life threatening condition usually caused by diabetes mellitus or alcohol. In this case report we present a lactating woman who developed a severe ketoacidosis a few weeks post partum. Her nutritional status was inadequate due to illness and a diet low on carbohydrates. Five case reports regarding ketoacidosis in lactating women have previously been described in the literature. This case report highlights the importance of nutrition during periods of breast feeding. Continue reading >>

Understanding And Treating Diabetic Ketoacidosis

Understanding And Treating Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of insulin production by the pancreatic b-cells or by inactivity or loss of insulin receptors, which are usually found on membranes of skeletal muscle, fat, and liver cells.1,3 In dogs and cats, DM is classified as either insulin-dependent (the body is unable to produce sufficient insulin) or non-insulin-dependent (the body produces insulin, but the tissues in the body are resistant to the insulin).4 Most dogs and cats that develop DKA have an insulin deficiency. Insulin has many functions, including the enhancement of glucose uptake by the cells for energy.1 Without insulin, the cells cannot access glucose, thereby causing them to undergo starvation.2 The unused glucose remains in the circulation, resulting in hyperglycemia. To provide cells with an alternative energy source, the body breaks down adipocytes, releasing free fatty acids (FFAs) into the bloodstream. The liver subsequently converts FFAs to triglycerides and ketone bodies. These ketone bodies (i.e., acetone, acetoacetic acid, b-hydroxybutyric acid) can be used as energy by the tissues when there is a lack of glucose or nutritional intake.1,2 The breakdown of fat, combined with the body's inability to use glucose, causes many pets with diabetes to present with weight loss, despite having a ravenous appetite. If diabetes is undiagnosed or uncontrolled, a series of metab Continue reading >>

Ketosis – What Is That All About?

Ketosis – What Is That All About?

What’s it all about? Is it good for you? Is it bad for you? What’s it like? How do I ‘do’ ketosis? How do I know I’m in ketosis? The questions everyone who’s Banting wants the answers to. Ketosis, in chef speak, is quite simply a state your body enters once it has been deprived of glucose. Your body switches to burning fat for energy (stored fat or fat that you have eaten) instead of glucose. A side-effect of that process is the release of ketone bodies into the blood stream. When you’re starved of glucose, your body has no choice but to burn fat for fuel, so it needs little explanation as to why ketosis works at melting fat like a blow heater on an ice sculpture. Ketosis comes with some added extras, namely a commonly noted sense of euphoria or lucidity and increased energy levels. A downside includes toothbrush-proof halitosis, which stems from the secretion of ammonia through the lungs as a side effect of burning all that fat. Some people on low-carb diets have reported kidney stones, gallstones and a number of other ailments. Scientific research on both sides of this debate is being done all the time, but in our experience from talking to the members of our community and tracking their data, it is generally a case of what was done before they started Banting and not Banting itself. But, this post isn’t here to debate that, it serves as a ‘how to’ and not as a ‘you should’. Eat more buttery or creamy sauce on your steak and eat less steak. Your body can convert protein into glucose so too much meat will hinder your progress. What doIdo? Theoretically it is very easy. Avoid anything with high carbs in it. If you’re not sure what those might be, consult the Real Meal Revolution ‘Red List’. Even dipping your toe into the red list will ruin Continue reading >>

Management Of Diabetic Ketoacidosis In Adults

Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes, making it a medical emergency. Nurses need to know how to identify and manage it and how to maintain electrolyte balance Continue reading >>

Management Of Feline Diabetic Ketoacidosis

Management Of Feline Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus with concurrent and often severe metabolic derangements associated with hyperglycaemia, glucosuria, metabolic acidosis, ketonaemia +/- ketonuria. Patients with ketonaemia/ketosis are usually still bright, eating and maintaining their hydration. Those with ketoacidosis are dehydrated, clinically unwell (e.g., anorexia, vomiting, lethargy) and typically require hospitalisation and intensive management. DKA is distinguished from uncomplicated diabetes mellitus (DM) by a relative insulin lack and increased counter-regulatory hormones. The latter are thought to occur secondary to intercurrent disease. Concurrent disease has been documented in approximately 90% of cats with DKA, with the most common being hepatic lipidosis, chronic kidney disease, acute pancreatitis, bacterial or viral infections and neoplasia (Bruskiewicz et al. 1997). Heinz bodies, neutrophilia with a left shift, increased ALT and azotaemia is common. Most cats presenting with DKA are newly diagnosed diabetics or recently diagnosed but poorly controlled diabetics. Diagnosis Hyperglycaemia, Glucosuria, Metabolic Acidosis Plus Ketones in Plasma and/or Urine Traditionally DKA has been diagnosed using urinary ketone dipsticks, which detect acetoacetate but not beta-hydroxybutyrate. However as the latter is the principle ketone body in DKA, measuring serum beta-hydroxybutyrate is a more sensitive indicator of DKA. In humans portable meters that measure beta-hydroxybutyrate in whole blood have largely superseded urine dipsticks. These ketone meters have recently proven useful in diagnosing DKA in cats, although they tend to underestimate beta-hydroxybutyrate at higher values (Zeugswetter, Rebuzzi 2012; Weingart et al. 2012). In the absence of a ke Continue reading >>

Ispad Clinical Practice Consensus Guidelines 2014

Ispad Clinical Practice Consensus Guidelines 2014

Editor in Chief: Mark A. Sperling, Pittsburgh, USA. Guest Editors: Carlo Acerini, Maria E Craig, Carine de Beaufort, David M Maahs and Ragnar Hanas. Introduction Carlo Acerini, Maria E Craig, Carine de Beaufort, David M Maahs and Ragnar Hanas. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 1–3. Uploaded: 2. Sept 2014 Download Introduction Chapter 1: Definition, epidemiology, diagnosis and classification Craig ME, Jefferies C, Dabelea D, Balde N, Seth A, Donaghue KC. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 4–17. Uploaded: 2. Sept 2014 Download Chapter 1 Chapter 2: Phases of Type 1 Diabetes Couper JJ, Haller MJ, Ziegler A-G, KnipM, Ludvigsson J, Craig ME. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 18–25. Download Chapter 2 Chapter 3: Type 2 diabetes Zeitler P, Fu J, Tandon N, Nadeau K, Urakami T, Bartlett T, Maahs D. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 26-46. Uploaded: 2. Sept 2014 Download Chapter 3 Chapter 4: The Diagnosis and Management of Monogenic diabetes Rubio-Cabezas O, Hattersley AT, Njølstad PR, Mlynarski W, Ellard S,White N, Chi DV, Craig ME. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 47-64. Uploaded: 2. Sept 2014 Download Chapter 4 Chapter 5: Management of cystic fibrosis-related diabetes Moran A, Pillay K, Becker DJ, Acerini CL. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 65-76. Uploaded: 2. Sept 2014 Download Chapter 5 Chapter 6: Diabetes education Lange K, Swift P, Pankowska E, Danne T. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 77-85. Uploaded: 2. Sept 2014 Download Chapter 6 Chapter 7: The delivery of ambulatory diabetes care Pihoker C, Forsander G, Fantahun B, Virmani A, Luo X, Hallman M, Wolfsdorf J, Maahs DM. Published in Pediatric Diabetes 2014: 15(Suppl. 20): 86-101. Up Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

DKA is usually signaled by high blood sugar levels. The important fact to remember is that without enough insulin, the body cannot burn glucose properly and fat comes out of fat cells. Diabetic Ketoacidosis (DKA) – a condition brought on by inadequate insulin – is a life-threatening emergency usually affecting people with type 1 diabetes. Although less common, it also can happen when you have type 2 diabetes. DKA is usually, but not always, signaled by high blood sugar levels. The important fact to remember is that without enough insulin, the body cannot burn glucose properly and fat comes out of fat cells. As a consequence the excess fat goes to the liver and glucose builds up in the bloodstream. The liver makes ketoacids (also known as ketones) out of the fat. Before long, the body is literally poisoning itself with excess glucose and ketoacids. What causes DKA? A lack of insulin usually due to: Unknown or newly diagnosed cases of type 1 diabetes Missed or inadequate doses of insulin, or spoiled insulin Infection Steroid medications An extremely stressful medical condition DKA is rare in type 2 diabetes – but can develop if someone with type 2 diabetes gets another serious medical condition. Examples of medical conditions associated with DKA in type 2 diabetes are severe infections, acute pancreatitis (inflammation of the insulin producing organ, the pancreas), and treatment with steroids. Symptoms of DKA include: Nausea, vomiting Stomach pain Fruity breath – the smell of ketoacids Frequent urination Excessive thirst Weakness, fatigue Speech problems, confusion or unconsciousness Heavy, deep breathing How do you know if you have DKA? Check your blood or urine for ketones. And if the test is positive, you will need immediate medical care. Treatment includes agg Continue reading >>

Defining Keto, And Ketosis Vs. Ketoacidosis

Defining Keto, And Ketosis Vs. Ketoacidosis

Ketosis Is Often Misunderstood And Confused With Ketoacidosis …A good number of less-informed doctors and medical professionals confuse ketoacidosis, a diabetic complication, with the dietary ketosis that is associated with ketogenic diets and fasting states in the body…which leads them to advise you that ketosis is dangerous. The truth is, ketosis and ketoacidosis are completely different, and nutritional ketosis is totally safe. Now, clearly, if you’ve had previous health problems involving your liver, kidneys, gallbladder, or pancreas, then you should seek advice from your doctor before making any changes to your diet, to insure your safety. Differentiating Nutritional Ketosis & Ketoacidosis First, let’s cover some semantics. Your body can produce, from fat and some amino acids, three ketone bodies (“ketone” refers to the chemical structure where oxygen is double-bonded to carbon sandwiched between at least two other carbons), which are: acetone, acetoacetone, and beta-hydroxybutyrate (B-OHB). And why does your body produce ketones? …Basically, it’s a key evolutionary advantage. Your brain can only function with glucose and ketones. And, since you can only store about 24 hours worth of glucose, you would die of hypoglycemia if you were ever forced to fast for longer than 24 hours. Quite fortunately, however, your liver can turn fat and certain amino acids (the building blocks of proteins) into ketones to feed our brains (among other uses). So the ability of our bodies to produce ketones is required for even basic survival. Next, what is diabetic ketoacidosis? …A diabetic person will effectively go into a state of starvation when they don’t receive enough insulin (typically a Type I diabetic, but sometimes in insulin-dependent Type II diabetics). T Continue reading >>

Ketones In Urine – How To Test And What Levels Are Optimal

Ketones In Urine – How To Test And What Levels Are Optimal

There are likely two reasons you want to test the ketone levels in your urine: REASON 1 – you’ve got type one diabetes (or type two diabetes, in some cases) and you need to test the ketones levels in your urine to help you avoid ketoacidosis. If that’s the case, skip down to the sections on… Then, skip straight to the section on… REASON 2 – you’re on the Keto diet and you want to use urine strips to check if you’re in ketosis. If that’s the case, then don’t worry we’ll also cover: But skip the section on ketoacidosis – it doesn’t apply to you unless you’re diabetic! Note that information contained in this article (and website) is not intended to and shall not convey or recommend any medical or nutritional advice or course of action. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professionals. All opinions expressed in this article are based solely on personal experiences and research. We are NOT licensed doctors, dietitians, or nutritionists. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com What are ketones? First things first – a quick 101 intro on what ketones actually are: Ketone bodies (or ketones) are produced by your liver during the break down of fatty acids when your body is low on glucose. Your body then uses these ketone bodies as fuel. You see, your cells can’t directly use the fatty acids in your fat stores to produce energy. And that’s because those fatty acids are unable to pass through the membrane which surrounds your cells. And if they can’t get inside? They can’t be used as fuel. So there’s an extra step to the process: First, the fatty acids travel to your liver where they’re broken down into ke Continue reading >>

Ketoacidosis Versus Ketosis

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 >>

Ketosis Vs. Ketoacidosis: Understanding The Differences

Ketosis Vs. Ketoacidosis: Understanding The Differences

Introduction to Ketosis vs Ketoacidosis Historically, ketosis has been one of the most vaguely defined and poorly understood concepts of the last century. There are different scenarios in which are body can be in a state of ketosis (including ketoacidosis). The most basic definition of ketosis is a general increase in blood levels of ketone bodies to 0.5 mmol or above. However, the reasons for the development of ketosis, the resultant levels of blood ketones, and the associated outcomes (health versus possible death) differ drastically between different situations of ketosis. Failure to understand the differences between various incidents of ketosis has led to the common misconceptions we have today that ultimately has made educating the masses on the ketogenic diet difficult. The single most important take home from this article should be that diabetic ketoacidosis is not the same as the ketosis experienced from a ketogenic diet. Diabetic Ketoacidosis Whenever I speak about ketogenic dieting, almost inevitably I am asked the question: “But shouldn’t you be worried about going into a state of ketoacidosis?” Ketoacidosis occurs when the formation ketone bodies are uncontrolled (15-25 mmol) and acidity in the blood increases (1). It is important to understand that our body regulates blood acid concentrations tightly. We typically measure blood acidity vs. alkalinity using the pH scale. If your blood’s pH is less than 7 it is acidic, and if greater it is basic, or alkaline. Our blood is usually slightly alkaline with a pH ranging from 7.35 to 7.45. Any deviation up or down from the norm by even the smallest amount can prove fatal! The most common form of ketoacidosis to occur is known as diabetic ketoacidosis. This usually occurs in type I diabetics but can also oc Continue reading >>

Beyond Weight Loss: A Review Of The Therapeutic Uses Of Very-low-carbohydrate (ketogenic) Diets

Beyond Weight Loss: A Review Of The Therapeutic Uses Of Very-low-carbohydrate (ketogenic) Diets

Very-low-carbohydrate diets or ketogenic diets have been in use since the 1920s as a therapy for epilepsy and can, in some cases, completely remove the need for medication. From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors. The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician’s hand. During recent years, an increasing amount of evidence has accumulated in the literature, suggesting that very-low-carbohydrate ketogenic diets (VLCKD) could have a therapeutic role in numerous diseases. The use of VLCKD in treating epilepsy has been well established for many decades and these diets have become even more widely known, as they became popular in the 1970s for weight loss—especially as the ‘Atkins Diet’.1 More recently, the therapeutic use of ketogenic diets in other diseases has been studied with positive results—it is an important direction for research because, clearly, Continue reading >>

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