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Nutritional Ketoacidosis

Ketosis Vs. Ketoacidosis (dka): What Is The Difference?

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 >>

Why Dka & Nutritional Ketosis Are Not The Same

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 >>

Alcoholic Ketoacidosis

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a metabolic complication of alcohol use and starvation characterized by hyperketonemia and anion gap metabolic acidosis without significant hyperglycemia. Alcoholic ketoacidosis causes nausea, vomiting, and abdominal pain. Diagnosis is by history and findings of ketoacidosis without hyperglycemia. Treatment is IV saline solution and dextrose infusion. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. Alcohol diminishes hepatic gluconeogenesis and leads to decreased insulin secretion, increased lipolysis, impaired fatty acid oxidation, and subsequent ketogenesis, causing an elevated anion gap metabolic acidosis. Counter-regulatory hormones are increased and may further inhibit insulin secretion. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs. Diagnosis requires a high index of suspicion; similar symptoms in an alcoholic patient may result from acute pancreatitis, methanol or ethylene glycol poisoning, or diabetic ketoacidosis (DKA). In patients suspected of having alcoholic ketoacidosis, serum electrolytes (including magnesium), BUN and creatinine, glucose, ketones, amylase, lipase, and plasma osmolality should be measured. Urine should be tested for ketones. Patients who appear significantly ill and those with positive ketones should have arterial blood gas and serum lactate measurement. The absence of hyperglycemia makes DKA improbable. Those with mild hyperglycemia may have underlying diabetes mellitus, which may be recognized by elevated levels of glycosylated Hb (HbA1c). Typical laboratory findings include a high anion gap metabolic acidosis, ketonemia, and low levels of potassium, magnesium, and phosphorus. Detection of acidosis may be com Continue reading >>

Grapefruit Derived Flavonoid Naringin Improves Ketoacidosis And Lipid Peroxidation In Type 1 Diabetes Rat Model

Grapefruit Derived Flavonoid Naringin Improves Ketoacidosis And Lipid Peroxidation In Type 1 Diabetes Rat Model

Abstract Hypoglycemic effects of grapefruit juice are well known but the effects of naringin, its main flavonoid on glucose intolerance and metabolic complications in type 1 diabetes are not known. Sprague-Dawley rats divided into 5 groups (n = 7) were orally treated daily with 3.0 ml/kg body weight (BW)/day of distilled water (group 1) or 50 mg/kg BW of naringin (groups 2 and 4, respectively). Groups 3, 4 and 5 were given a single intra-peritoneal injection of 60 mg/kg BW of streptozotocin to induce diabetes. Group 3 was further treated with subcutaneous insulin (4.0 IU/kg BW) twice daily, respectively. Stretozotocin (STZ) only-treated groups exhibited hyperglycemia, polydipsia, polyuria, weight loss, glucose intolerance, low fasting plasma insulin and reduced hepatic glycogen content compared to the control group. Furthermore they had significantly elevated Malondialdehyde (MDA), acetoacetate, β-hydroxybutyrate, anion gap and significantly reduced blood pH and plasma bicarbonate compared to the control group. Naringin treatment significantly improved Fasting Plasma Insulin (FPI), hepatic glycogen content, malondialdehyde, β-hydroxybutyrate, acetoacetate, bicarbonate, blood pH and anion gap but not Fasting Blood Glucose (FBG) compared to the STZ only-treated group. Figures Citation: Murunga AN, Miruka DO, Driver C, Nkomo FS, Cobongela SZZ, Owira PMO (2016) Grapefruit Derived Flavonoid Naringin Improves Ketoacidosis and Lipid Peroxidation in Type 1 Diabetes Rat Model. PLoS ONE 11(4): e0153241. Editor: Bridget Wagner, Broad Institute of Harvard and MIT, UNITED STATES Received: January 5, 2016; Accepted: March 27, 2016; Published: April 13, 2016 Copyright: © 2016 Murunga et al. This is an open access article distributed under the terms of the Creative Commons Attributi Continue reading >>

Ketosis Vs. Ketoacidosis: What You Should Know

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Source Diabetic ketoacidosis (DKA), often referred to as diabetic coma, is a serious medical situation for individuals with type 1 diabetes. This condition is extremely rare in people with type 2 diabetes. However, type 2 diabetics can experience a non-ketotic syndrome. While the information below focuses on DKA, both conditions can lead to coma, shock, respiratory distress, and death. Luckily, with proper healthcare intervention and continual attention and monitoring, the life-threatening conditions of diabetes can be avoided. What is Diabetic Ketoacidosis? When the amount of sugar rises in the blood, normal metabolic functions begin to malfunction and fail. One disruption is the proper acidity level of the blood. The substance behind the acidity: ketones. When your body does not have enough insulin, such as in untreated diabetes, muscles are unable to get the glucose they require. When they are starved of this nourishment, fat is broken down for their energy source. Ketones are the by-product of this breakdown. When your body does not excrete them faster than they form, the blood becomes poisoned by its high acid levels. Another aspect of DKA is dehydration. This state occurs because glucose is flowing into your urine, while at the same time, your kidneys are producing more urine. The excessive excretion of all this fluid causes the dehydration. Why It Happens An increased blood sugar level is the direct result of an inadequate supply of insulin or the malfunctioning of the insulin that is present. Insulin is a hormone made in the pancreas, which is located in the lower left side of the abdomen. Its production is triggered by the presence of sugar, also known as glucose, in the bloodstream. If insulin is not made or not working properly, glucose is not transported out 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 >>

Ketosis: Fear, Uncertainty And Doubt

Ketosis: Fear, Uncertainty And Doubt

Perhaps nothing is more damaging to the new low-carber than the intentional spread of fear, uncertainty and doubt regarding the state of ketosis compared to the dangerous state of ketoacidosis. The former is a natural and healthy state of existence, the latter is a condition that threatens the life of type 1 diabetics and type 2 diabetics whose disease has progressed to the point where their pancreatic beta cells can no longer produce insulin (ketoacidosis is also a risk for alcoholics). So if you’re not an alcoholic, a type 1 diabetic or a late-stage type 2 diabetic, fear of ketosis is misdirected. You should regard with suspicion anyone who confuses the two and warns you against a low-carb diet because they cannot tell the difference. The confusion between ketosis and ketoacidosis is a sign of a grave misunderstanding of basic biology (if not a complete lack of critical faculty). So too is the assumption that ketosis is the “early stage” of ketoacidosis or that “ketosis leads to ketoacidosis” in a person whose pancreas is still able to produce insulin. If you don’t trust me (and why should you), you should consider listening to some people who know a lot more about this than either you or I ever will: Nutritional ketosis is by definition a benign metabolic state… by contrast, ‘diabetic ketoacidosis’ is an unstable and dangerous condition that occurs when there is inadequate pancreatic insulin response to regulate serum B-OHB. This occurs only in type-1 diabetics or in late stage type-2 diabetics with advanced pancreatic burnout. (Dr. Phinney & Dr. Volek, The Art and Science of Low Carbohydrate Living, p.4) Later in the book (p.80), Phinney and Volek explain further: [Type-1 diabetics] need insulin injections not just to control blood glucose levels, 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 >>

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 >>

Sglt2 Inhibitors

Sglt2 Inhibitors

SGLT2 inhibitors are not indicated for treatment of adults with type 1 diabetes mellitus, a metabolic disorder that also is characterized by hyperglycemia. In type 1 diabetics, however, the pancreas produces little to no insulin. Sodium glucose cotransporter-2 (SGLT2) inhibitors are a novel class of antihyperglycemics designed to work against SGLT2, a low-affinity, high-capacity transporter protein found in the kidney’s proximal tubules. The mechanism for SGLT2 inhibitors involves preventing the excretion of urinary glucose by reabsorbing glucose. SGLT2 inhibitors discourage this reuptake of glucose in the kidney. SGLT2 inhibitors are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, a metabolic disorder commonly characterized by hyperglycemia (high blood sugar) and inadequate levels of insulin or insulin resistance. Some SGLT2 inhibitors have been linked to side effects ranging from UTIs to kidney problems, amputations, bladder cancer and diabetic ketoacidosis (dka). Using SGLT2 inhibitors for the Treatment of Type 2 Diabetes Generally, SGLT2 inhibitors are taken orally once per day, usually before breakfast. Your doctor will prescribe the strength of the pill and tell you exactly how and when to take it. The dose may be changed if your doctor decides doing so would be more beneficial for you. While taking an SGLT2 inhibitor, your doctor may advise you to check your blood sugar levels in accordance with a particular schedule. Be aware that SGLT2 inhibitors will be likely to cause your urine to test positive for glucose. Your doctor may also order tests to check your blood sugar levels and hemoglobin A1C while taking SGLT2 inhibitors. Your doctor may periodically order these same tests, and possibly other Continue reading >>

Difference Between Ketosis And Diabetic Ketoacidosis

Difference Between Ketosis And Diabetic Ketoacidosis

There is a distinct difference between Diabetic Ketoacidosis, Nutritional Ketosis, and Exogenous Ketones. Diabetic ketoacidosis is a dangerous state that occurs in the absence of insulin. What happens is your blood sugar levels rise, but it’s insulin that needs to pull the sugar out of the blood into the cells. This absence of insulin results in the blood not being able to deplete itself of the sugar, and the sugar will not be absorbed into the cells. So your body thinks it’s starved of energy in the absence of blood sugars and begins producing abnormal amounts of ketones. There is nothing to manage the production of ketones and blood sugar, ending up with very high levels of both, which can be quite dangerous. Diabetic ketoacidosis can’t happen if there is enough insulin present in the body. Nutritional ketosis is the process of your body breaking down fat as a source of fuel and creating ketones. This only happens when following a low carbohydrate – high fat diet. Exogenous ketones, such as KETO//OS, are ketone bodies that you can take and absorb into your body without being in a state of nutritional ketosis. Taking exogenous ketones will elevate your level of ketones for 3 – 6 hours. There are many benefits to taking exogenous ketones as well. So is a ketone supplement, such as KETO//OS, safe to take for diabetics? If you are a controlled diabetic, and you’ve been approved by your healthcare provider to take exogenous ketones. Then yes, it’s quite safe. And, there could be a great benefit due to the beneficial impact of insulin sensitivity that is associated with ketones and bhb (beta hydroxybutyrate). It’s important to remember to manage your blood ketone levels as much as you manage your blood sugar levels. Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

Duck Dodgers October 14, 2014 Peter, An article by Per Wikholm was published in this month’s LCHF Magasinet, where Per demonstrates that the Inuit could not have been in ketosis given that the scientific literature is abundantly clear, over and over again, that the Inuit consumed too much protein, and more importantly, Per debunks Stefansson’s claims for high fat with writing from his own books—Stef admitted in the pemmican recipes that Arctic caribou was too lean to make pemmican that supported ketosis. The most popular LCHF bloggers in Sweden, Andreas Eenfeldt/Diet Doctor and Annika Dahlquist have reluctantly agreed with Per’s findings—admitting that the Inuit were likely not ketogenic from their diet. I’ve put together a comprehensive review of the scientific literature regarding the Inuit, encompassing over two dozen studies, spanning 150 years, with references from explorers, including Stefansson. In the comments section of that post, Per gives a brief overview of how he was able to prove Stefansson’s observations on high fat intake were flawed. The post is a review of all the available literature that I could find (over two dozen studies). But, the literature certainly does not in any way support ketosis from the Inuit diet due to such high protein consumption. As Per (and Stefansson) points out, the caribou is too lean and as the many quotes show, the Inuit were saving their blubber and fat for the long dark Winter to power their oil lamps and heat their igloos. Again and again, we see that in the literature, as even Stefansson admits this. As far as glycogen is concerned, their glycogen intake is probably not worth scrutinizing given the well-documented high protein consumption in every published study. It really is besides the point. But, interest Continue reading >>

A Comprehensive Beginner's Guide

A Comprehensive Beginner's Guide

What is a Keto Diet? A keto diet is well known for being a low carb diet, where the body produces ketones in the liver to be used as energy. It’s referred to as many different names – ketogenic diet, low carb diet, low carb high fat (LCHF), etc. When you eat something high in carbs, your body will produce glucose and insulin. Glucose is the easiest molecule for your body to convert and use as energy so that it will be chosen over any other energy source. Insulin is produced to process the glucose in your bloodstream by taking it around the body. Since the glucose is being used as a primary energy, your fats are not needed and are therefore stored. Typically on a normal, higher carbohydrate diet, the body will use glucose as the main form of energy. By lowering the intake of carbs, the body is induced into a state known as ketosis. Ketosis is a natural process the body initiates to help us survive when food intake is low. During this state, we produce ketones, which are produced from the breakdown of fats in the liver. The end goal of a properly maintained keto diet is to force your body into this metabolic state. We don’t do this through starvation of calories but starvation of carbohydrates. Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits. Make keto simple and easy by checking out our 30 Day Meal Plan. Get meal plans, shopping lists, and much more with our Keto Academy Program. Looking for Something Specific? There are numerous benefits that come with being on keto: from weight loss and increased energy levels to therapeutic medical appl Continue reading >>

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