Diabetes: What Is Ketoacidosis And How Can Be Avoided & Treated?
Good question! According to Wikipedia: Diabetic ketoacidosis is a potentially life-threatening complication in patients with diabetes mellitus. In order to define ketoacidosis a little better, let's go back to the source: diabetes. Someone who is diabetic is unable to produce insulin, a hormone necessary for the transfer of sugar from the bloodstream to the cells, which in turn produce energy. If this progression is disrupted, through lack of insulin for example, the body has to try to compensate by creating energy elsewhere. And so the body starts to burn fat and muscle to meet its energy needs. Unfortunately, this chemical reaction produces molecules known as ketone bodies. In small quantities, these are fine, and it is in fact normal to have traces of them in your blood (approximately 1mg/dl). However, if the quantity of ketones surpasses this threshold by too much, it starts to affect the pH of your blood (which becomes progressively more acidic). Even the slightest drop in pH can have dangerous effects: as the quantity of the ketones in your blood increases, and the blood pH diminishes, your kidneys start having problems. Eventually, if the ketoacidosis is left untreated, your kidneys can fail and you can die from dehydration, tachycardia and hypotension. A number of other symptoms can appear in extreme cases. Fortunately for us, the quantity of ketones has to be consequential, and it usually takes a while before individuals start manifesting symptoms. In my case, my diabetes went undiagnosed for a month and a half before it was discovered, and even then my ketone levels were relatively normal. If you're a diabetic, ketoacidosis can be easily avoided by controlling your blood sugar levels and maintaining a healthy lifestyle. Some doctors, preferring to stay on the Continue reading >>
Ketones Urine Test
Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. Continue reading >>
How Is Methylglyoxal Produced In Ketosis?
As dry as this question sounds, this is a fascinating and relevant topic. At its heart lies the issue of how diabetes (and possibly low-carb diets) can predispose you to atherosclerosis. And heart attacks (pun totally unintended). But to get there, we have to review some chemistry. That's where methylglyoxal and ketosis come in. Bear with me. Above is a useful summary diagram. Keep reading for more details on the actual processes. To clarify: ketosis is not a chemical reaction per se. It's the state where the body derives most of its energy supply by metabolizing ketone bodies. Normally, we derive most of our energy through glycolysis and the concentration of ketone bodies is less than 0.5mM . Levels above this are associated with ketosis. For example, diabetics with severe ketosis might have concentrations of 10mM . The liver produces ketones from fats to meet the body's energy needs when there is a lack of glucose and glycogen. So you can see why ketosis might arise not just in diabetics, but also in people on low-carb diets like the Atkins . Fat (triacylglycerol) is broken down into three fatty acid chains and one glycerol molecule (this process is called lipolysis). The body uses these fatty acids as an energy source in a process called beta-oxidation, which produces acetyl-CoA. When glycogen and glucose levels are low (e.g. due to starvation, fasting, or a ketogenic diet), the liver converts acetyl-CoA into ketone bodies: Here are some common ketone bodies: From top to bottom: acetone (the stuff of nail polish remover), acetoacetic acid, beta-hydroxybutyric acid So if we go back to Figure 1 , we see that some of the ketones produced by the liver are also the precursors of methylglyoxal, which is a metabolic toxin. What's bad about methylglyoxal? For one Continue reading >>
How Long Does It Take To Get Back Into Ketosis?
This very much depends on how far along you are in your diet, how adapted you are and what your diet actually looks like (how low carb it truly is.) In the early stages, particularly if you’re not exercising (e.g. doing something that will actively help deplete your glycogen stores) then unfortunately it may well take about as long as it previously took you to get back into ketosis. You’ll just have to bite your tongue and “get back on the horse.” What are you using to measure your ketone levels? It is ideally advisable to get a blood glucose/ketone meter if you can (such as the Abbott Freestyle Optium Neo, which is what I use) to get a more accurate picture of your blood ketone and sugar levels. Unfortunately the ketone strips are not exactly cheap (Ebay is your friend however.) Further things (hacks) you could perhaps try to help speed up the process: Do 2 hours of cardio if you’re fit enough and able to do so (this should burn very roughly about 2000 kcal or so and therefore be approximately enough to mostly blow through your glycogen stores.) Use some MCT/coconut oil (preferably “XCT oil” or “Brain Octane” although again these are not cheap) in your diet. 1 or 2 teaspoons of Brain Octane should help get back into ketosis more quickly. Personally I have become accustomed to and quite like it in my coffee, this is so called “Bulletproof coffee”. (Don’t overdo it though, this is artificially introducing ketones into your system to help “prime the pump” but ultimately you want your liver to be producing its own ketones. Nonetheless this does seem to help speed adaptation and ketosis.) If you’re familiar with Intermittent Fasting, then you could do an 18/6 IF diet for a day or 2. The simplest way to accomplish this is to ensure you have your Continue reading >>
What Are The Optimal Ketone Levels For A Ketogenic Diet?
If you’ve just started a ketogenic diet, then you’ll know that it can be really tough to figure out if you’re doing keto right. Am I eating too many carbs? Too much protein? Should I still be feeling tired? When is the fat burning supposed to start? It’s confusing, and one of the most confusing aspects is what your optimal ketone levels are supposed to be. Unlike most other diets, the ketogenic diet is designed to put your body into a state of ketosis in order to get your body to start burning ketones instead of the glucose that it usually burns when you eat a high carb standard American diet (SAD). But to know whether you’re in ketosis and whether your body has enough ketones circulating for you to use as energy instead of glucose, you have to measure your actual ketone levels and then determine whether they’re high enough for you to be reaping the benefits of the ketogenic diet. If you’ve tried searching for this information already, then you’ll know that there’s some controversy depending on which expert you follow. So in this article, we’ll tell you exactly what the different experts are suggesting are the optimal ketone levels as well as give you recommendations for what ketone levels you should be aiming for depending on your goals with a ketogenic diet. A Few Quick Notes Before We Start… If you’re looking for signs other than testing your actual body ketone levels as to whether you’re in ketosis or not, then please check out this article instead that provides you with signs you’re in ketosis. If you’re a type 1 diabetic, then this article is not for you and the optimal ketone levels suggested below are not applicable to you. Please check out the tons of other ketone level articles on the web to ensure your ketone levels do not reach Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Does the Ketogenic Diet Work for Type 2 Diabetes?
Getting To Know Ketones
People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f 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 >>
- Tiny sensor placed under the skin to replace finger prick tests for diabetes: Smartphone app will alert patients if their blood sugar level drops or is too high
- Insulin, glucagon and somatostatin stores in the pancreas of subjects with type-2 diabetes and their lean and obese non-diabetic controls
- Are ketones dangerous?
Ketosis & Measuring Ketones
Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>
What Are Normal Blood Glucose And Ketone Levels?
Elevated insulin and blood glucose levels are associated with a wide range of health issues including obesity, mental health, cancer, cardiovascular disease, and stroke. “Normal” blood sugars are not necessarily optimal for long-term health. Most people are somewhere on the spectrum between optimal blood sugars and full-blown Type 2 Diabetes. Maintaining blood sugars closer to optimum levels is possibly the most important thing you can do to manage your health, reduce body fat and slow ageing. Blood ketones tend to rise as blood glucose levels decrease, though they can vary depending on a number of factors. People who are physically fit and/or who have been following a ketogenic lifestyle for a long period do not tend to show very high blood ketone levels. “Diabetes” refers to a group of metabolic diseases where a person has high blood sugars over an extended period of time. Diabetes is expensive. In 2012 it cost the US a quarter of a trillion dollars in hospital costs and lost productivity and the cost of “diabesity” is forecast to triple by 2050 grow and become a major burden our economy. Diabesity has even been classed as a matter of economic and national security (Pompkin, 2013). One in twelve people are considered to have Type 2 diabetes, however, forty percent of the US population is considered to be “pre-diabetic” and this number is forecast to grow by more than half over the next two decades to 592 million people by 2035. If you have prediabetes you have a one in two chance of progressing to Type 2 Diabetes within five years. The generally accepted diagnosis levels for prediabetes and Type 2 Diabetes are shown in the table below. fasting after meal hbA1c % pop mg/dL mmol/L mg/dL mmol/L % “normal” < 100 < 5.6 < 140 < 7.8 < 6.0% 50% pre-diabeti Continue reading >>
Urine Tests For Diabetes: Glucose Levels And Ketones
The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Renal Handling of Ketones in Response to Sodium–Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes
- Diabetes Alert: Biotin and Chromium Help Control Glucose Levels
Are Both Type 1 And Type 2 Diabetes Patients At The Risk Of Death?
Are both type 1 and type 2 diabetes patients at the risk of death? Yes, absolutely. Every single person on the planet with Type 1 and Type 2 diabetes will die. But don’t worry, so will everyone else - it is all just a matter of time. The real question should be are they at risk of a premature death due to their conditions, and unfortunately the answer to that is also yes for various reasons. The first reason is the impact of long-term high blood glucose levels, including damage to large and small blood vessels, which can lead to heart attack and stroke, and problems with the kidneys, eyes, feet and nerves. Another risk often overlooked is overdosing on insulin. Insulin is a highly dangerous hormone, taking too much will cause a person to slip into a hypoglycemic coma which can lead to death. Alternatively, it is possible to die from not getting enough (or any insulin), due to Diabetic ketoacidosis Continue reading >>
How To Know If You’re In Ketosis: A Guide To Testing Ketone Levels
Ketosis can be a powerful way to use your metabolism for fat loss, mental output, physical performance as well as many other health benefits. But how do you know if you’re actually in ketosis? As the old adage goes “test, don’t guess” when it comes to your health. In this guide, we’ll show exactly how to test your ketone levels to know if you’re in ketosis so you can make sure you’re getting all of the benefits that ketosis has to offer. There are three primary forms of ketones in your body, acetone, acetoacetate, and beta-hydroxybutryate. Each of these compounds do different things in the metabolism of ketosis and can be tested individually with differing techniques. Not all measurement is created equally, however, and some can be better than others for different purposes or times. The three different ketone bodies can be measured when they spill over into three different areas of your body: your breath, urine or blood. The good news is that all of these ketone level measurements can be done at home, by yourself. You don’t have to go to any lab or use any fancy high tech equipment. Tracking diligently, at least when you’re getting used to ketosis based diets, is important so you know how much you react to different variables like exercise, type and amount of food, and amounts of exogenous ketone supplements. Also, the optimal level of ketones for specific goals can vary per person. Knowing the amount where you thrive in the goal you want to achieve (and consistently checking if you’re hitting that amount) is the fastest way to reach your goals. Testing levels of ketones with urine strips (acetoacetate) One of the ketone bodies, acetoacetate, can be measured directly in the urine if they are in excessive levels. The way metabolic substrates get into Continue reading >>
What Are Ketone Bodies And How Are They Related To Diabetes?
What are ketones? The human body normally runs on glucose that’s produced when the body breaks down carbohydrates. But when your body doesn’t have enough glucose or insulin to use the glucose, your body starts breaking down fats for energy. Ketones are byproducts of this breakdown. Those with type 1 diabetes are especially at risk for making ketones. Ketones can make your blood acidic. Acidic blood can cause a serious condition known as diabetic ketoacidosis (DKA). Because the presence of ketones is often one of the signs that a person needs medical help, those with diabetes are often encouraged to check ketones in urine or blood regularly. Ketone levels can range from negative or none at all to very high levels. While individual testing may vary, some general results for ketone levels can be: negative: less than 0.6 millimoles per liter (mmol/L) low to moderate: between 0.6 to 1.5 mmol/L high: 1.6 to 3.0 mmol/L very high: greater than 3.0 mmol/L Call your doctor if your ketones are low to moderate, and seek emergency medical attention if your ketone levels are high to very high. What are the symptoms of ketone buildup? If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. Examples of early symptoms of ketone buildup include: a dry mouth blood sugar levels greater than 240 milligrams per deciliter strong thirst frequent urination If you don’t get treatment, the symptoms can progress. The symptoms that occur later can include: confusion extreme fatigue flushed skin a fruity breath odor nausea vomiting stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. What causes ketones to build up? Ketones are the body’s alternate way of fueling. T Continue reading >>
Tweet Ketone testing is a key part of type 1 diabetes management as it helps to prevent a dangerous short term complication, ketoacidosis, from occurring. If you have type 1 diabetes, it is recommended that you have ketone testing supplies on your prescription. Ketone testing may also be useful in people with other types of diabetes that are dependent upon insulin. Why test for ketones? Ketones are produced by the body as an alternative source of energy to sugar. The body produces ketones by breaking down fats, this process is known as ketosis. Ketones may be produced as part of weight loss, however, it’s important for people with diabetes on insulin to note that ketones can be produced when the body has insufficient insulin. When the body has too little insulin, it means that cells of the body cannot take in enough sugar from the blood. To compensate for this, the body will start to break down fat to provide ketones. However, if a high level of ketones is produced, this can cause the blood to become acidic which can lead to illness and even potential danger to organs if not treated in time. This state is referred to as diabetic ketoacidosis. Where can I get ketone testing kits and sensors? The most accurate way of testing for ketones is to use a meter that measures blood ketone levels. The following blood glucose meters are able to test blood ketone levels in addition to blood glucose levels: Abbott - FreeStyle Optium Neo Menarini - GlucoMen LX Plus If you take insulin, you should be able to get these prescribed by your GP. You can also test urine for ketone levels, however, urine ketone testing is not as accurate as blood ketone testing as the levels of ketones in the urine will usually only reflect a level of up to a few hours previously. When to test for ketones? Continue reading >>
Acetoacetate, beta-hydroxybutyrate, and acetone are ketone bodies. In carbohydrate-deficient states, fatty-acid metabolism spurs acetoacetate accumulation. The reduction of acetoacetate in the mitochondria results in beta-hydroxybutyrate production. Beta-hydroxybutyrate and acetoacetate, the predominant ketone bodies, are rich in energy. Beta-hydroxybutyrate and acetoacetate transport energy from the liver to other tissues. Acetone forms from the spontaneous decarboxylation of acetoacetate. Acetone is the cause of the sweet odor on the breath in persons with ketoacidosis. [1, 2] Ketone bodies fuel the brain with an alternative source of energy (close to two thirds of its needs) during periods of prolonged fasting or starvation, when the brain cannot use fatty acids for energy. The reference range for ketone is a negative value, at less than 1 mg/dL (< 0.1 mmol/L).  Continue reading >>