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What Does Ketoacidosis Mean?

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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 Continue reading >>

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Popular Questions

  1. Nathan Wheeler

    I know that a lot of runners stock up on carbs before a run. What is the benefit of this? I've heard some people say that you'll "hit a wall" if you don't take in some carbs before running. I'm assuming this is like hitting a plateau in your running ability where you can't progress any further. Is this true?
    I'm on a ketogenic diet (low/no-carb) normally, but it seems I definitely perform better when I have some carbs before a run. Why do carbs make such a big difference during exercise while ketone bodies are fine for fuel all the rest of the day?

  2. Barbie

    "Hitting the wall" isn't so much a plateau as "precipitous fatigue and loss of energy" (Wikipedia). It happens when you run out of glycogen (the storage for of carbohydrate in your body). When I was training for a marathon a couple years back, I went out on a 16 mile run without bringing a source of carbs along. For my first 10 miles (~1h 20min) I had an average pace of 8:21 minutes/mile. After that I started to hit the wall and my pace dropped to 10:40 min/mile. After about 3 miles like that, I was totally depleted had to walk the last 3 miles home. There was just no more energy available. Eating carbs before (and during, if it's really long) helps prevent this by topping my glycogen stores. Many athletes even carb load the week before an event to maximize glycogen stores.
    Every nutrition textbook I've read has recommended a high carb diet as definitively the best plan for endurance athletes (Here's the relevant section in the Nutrition textbook my university uses). However, I found an article with a differing viewpoint. According to the author, people on a high protein diet can maintain their endurance performance if given enough time to adapt to using ketones. This may take 3-4 weeks. However, apparently if you wax and wane on your ketogenic diet (sometimes eating carbs, sometimes not), your body wont adapt; you have to be consistent. The author also explains that there are a couple things you have to be careful about when exercising on a ketogenic diet:
    Ketogenic diets cause diuresis (water loss) which can take minerals with it. If you're on this kind of diet, you may need to supplement your electrolytes. A scary running-related health issue that pops up in the media every summer is hyponatremia, which is caused by losing too many electrolytes.
    If you don't have enough dietary protein to meet your exercise needs, your body will start drawing protein from its "stores," i.e. your muscles (discussed more here). Just because you're on a high protein diet doesn't automatically mean you're consuming enough protein, since the point is often to reduce total calories so you can lose weight. The author recommends you consume 1.2 – 1.7 g of protein per kilogram body mass, and says that if protein intake exceeds 25% of your caloric intake there are negative side effects (protein yields 4 Cal/g, so to figure about how many grams of protein you're allowed, calculate 0.25 * [total Calories consumed] / [4 Cal/g]).
    Given all this information, I can think of one additional concern. To prevent your body from tapping into your muscles to get energy during prolonged endurance, you would have to eat protein during exercise. Protein is known to delay gastic emptying (it stays in your stomach for longer), so it's not pleasant to eat during exercise.
    The author also squeezes in one final caveat at the end:
    Anaerobic (ie, weight lifting or sprint) performance is limited by the low muscle glycogen levels induced by a ketogenic diet, and this would strongly discourage its use under most conditions of competitive athletics.
    If I recall correctly, you do interval training, which may push you into the anaerobic zone. If this is the case, it sounds like a ketogenic diet would negatively affect your performance. I'm having a hard time finding a source to explain why this is the case, but maybe it's because anaerobic exercise uses glucose as its primary energy source (you rely more on fat during aerobic exercise and at rest), so large amounts of it would have to be synthesized from protein; maybe the body can't keep up with the demand.

  3. Nick

    To put it simply, carbs are going to act as your fuel. Loading up on carbs prior to a run is like filling up your gas tank before driving a long distance.

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