Diabetes And Ketones
Tweet The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis. Ketones build up when there is insufficient insulin to help fuel the body’s cells. High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes. If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible. What are ketones? Ketones are an acid remaining when the body burns its own fat. When the body has insufficient insulin, it cannot get glucose from the blood into the body's cells to use as energy and will instead begin to burn fat. The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy. It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned. In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis. How do I test for ketones? Ketone testing can be carried out at home. The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels. You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago. Read about testing for ketones and how to interpret the results Who needs to be aware of ketones? The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis: Anyone dependent on insulin – such as all people Continue reading >>
Ketosis: Metabolic Flexibility In Action
Ketosis is an energy state that your body uses to provide an alternative fuel when glucose availability is low. It happens to all humans when fasting or when carbohydrate intake is lowered. The process of creating ketones is a normal metabolic alternative designed to keep us alive if we go without food for long periods of time. Eating a diet low in carb and higher in fat enhances this process without the gnawing hunger of fasting. Let’s talk about why ketones are better than glucose for most cellular fuel needs. Legionella Testing Lab - High Quality Lab Results CDC ELITE & NYSDOH ELAP Certified - Fast Results North America Lab Locations legionellatesting.com Body Fuel Basics Normal body cells metabolize food nutrients and oxygen during cellular “respiration”, a set of metabolic pathways in which ATP (adenosine triphosphate), our main cellular energy source is created. Most of this energy production happens in the mitochondria, tiny cell parts which act as powerhouses or fueling stations. There are two primary types of food-based fuel that our cells can use to produce energy: The first cellular fuel is glucose, which is commonly known as blood sugar. Glucose is a product of the starches and sugars (carbohydrates) and protein in our diet. This fuel system is necessary, but it has a limitation. The human body can only store about 1000-1600 calories of glucose in the form of glycogen in our muscles and liver. The amounts stored depend on how much muscle mass is available. Men will be able to store more because they have a greater muscle mass. Since most people use up about 2000 calories a day just being and doing normal stuff, you can see that if the human body depended on only sugar to fuel itself, and food weren’t available for more than a day, the body would run Continue reading >>
Ketone Body Metabolism
Ketone body metabolism includes ketone body synthesis (ketogenesis) and breakdown (ketolysis). When the body goes from the fed to the fasted state the liver switches from an organ of carbohydrate utilization and fatty acid synthesis to one of fatty acid oxidation and ketone body production. This metabolic switch is amplified in uncontrolled diabetes. In these states the fat-derived energy (ketone bodies) generated in the liver enter the blood stream and are used by other organs, such as the brain, heart, kidney cortex and skeletal muscle. Ketone bodies are particularly important for the brain which has no other substantial non-glucose-derived energy source. The two main ketone bodies are acetoacetate (AcAc) and 3-hydroxybutyrate (3HB) also referred to as β-hydroxybutyrate, with acetone the third, and least abundant. Ketone bodies are always present in the blood and their levels increase during fasting and prolonged exercise. After an over-night fast, ketone bodies supply 2–6% of the body's energy requirements, while they supply 30–40% of the energy needs after a 3-day fast. When they build up in the blood they spill over into the urine. The presence of elevated ketone bodies in the blood is termed ketosis and the presence of ketone bodies in the urine is called ketonuria. The body can also rid itself of acetone through the lungs which gives the breath a fruity odour. Diabetes is the most common pathological cause of elevated blood ketones. In diabetic ketoacidosis, high levels of ketone bodies are produced in response to low insulin levels and high levels of counter-regulatory hormones. Ketone bodies The term ‘ketone bodies’ refers to three molecules, acetoacetate (AcAc), 3-hydroxybutyrate (3HB) and acetone (Figure 1). 3HB is formed from the reduction of AcAc i Continue reading >>
Ketone bodies Acetone Acetoacetic acid (R)-beta-Hydroxybutyric acid Ketone bodies are three water-soluble molecules (acetoacetate, beta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced by the liver from fatty acids during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise,, alcoholism or in untreated (or inadequately treated) type 1 diabetes mellitus. These ketone bodies are readily picked up by the extra-hepatic tissues, and converted into acetyl-CoA which then enters the citric acid cycle and is oxidized in the mitochondria for energy. In the brain, ketone bodies are also used to make acetyl-CoA into long-chain fatty acids. Ketone bodies are produced by the liver under the circumstances listed above (i.e. fasting, starving, low carbohydrate diets, prolonged exercise and untreated type 1 diabetes mellitus) as a result of intense gluconeogenesis, which is the production of glucose from non-carbohydrate sources (not including fatty acids). They are therefore always released into the blood by the liver together with newly produced glucose, after the liver glycogen stores have been depleted (these glycogen stores are depleted after only 24 hours of fasting). When two acetyl-CoA molecules lose their -CoAs, (or Co-enzyme A groups) they can form a (covalent) dimer called acetoacetate. Beta-hydroxybutyrate is a reduced form of acetoacetate, in which the ketone group is converted into an alcohol (or hydroxyl) group (see illustration on the right). Both are 4-carbon molecules, that can readily be converted back into acetyl-CoA by most tissues of the body, with the notable exception of the liver. Acetone is the decarboxylated form of acetoacetate which cannot be converted Continue reading >>
What Are Ketones And Are They Healthy?
What Are Ketones and Are They Healthy? If you are up on your health news or follow anyone in the health field, you have likely heard the term ketogenic diet. The goal of the ketogenic diet is to adapt the body to utilize fat as its primary fuel source instead of sugar. The body does this by first converting fat into what are called ketones that the cells can then burn as fuel. It is at this point that I typically get asked, what are ketones? In this article, I am going to clear up any gaps, explain exactly how ketogenisis works, and why it can be so beneficial for the human body. Biological Role of Ketones For our ancestors, eating three meals a day just wasn’t a thing. Instead they would hunt and forage for the foods they could find. When there wasn’t food, they wouldn’t eat. What this means is that sometimes they would go for days at a time with no food. To sustain life during times of scarcity, the body is thought to have developed the ability to utilize fat as an alternative fuel source. In a traditional nutrition course, you would learn that sugar is the body’s primary fuel source while fat is a secondary fuel source. When sugar stores are burned up, the cells then convert to burning fat as an energy source. What we are finding out now is that fat can actually be a healthier and more sustainable source of energy. Our Society Is Full of Sugar Burners Modern day, we have an abundance of food that is available to us at all times. Most of us regularly eat three meals a day with intermittent snacking in between. This kind of frequent eating, along with an overemphasis on carb-rich and sugary foods, causes a reduced ability to burn fat. As these foods damage our bodies on a metabolic level, we actually lose the ability to produce ketones. This type of reliance on 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 >>
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Ketone Bodies: A Review Of Physiology, Pathophysiology And Application Of Monitoring To Diabetes.
Abstract Ketone bodies are produced by the liver and used peripherally as an energy source when glucose is not readily available. The two main ketone bodies are acetoacetate (AcAc) and 3-beta-hydroxybutyrate (3HB), while acetone is the third, and least abundant, ketone body. Ketones are always present in the blood and their levels increase during fasting and prolonged exercise. They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones. In diabetic ketoacidosis (DKA), high levels of ketones are produced in response to low insulin levels and high levels of counterregulatory hormones. In acute DKA, the ketone body ratio (3HB:AcAc) rises from normal (1:1) to as high as 10:1. In response to insulin therapy, 3HB levels commonly decrease long before AcAc levels. The frequently employed nitroprusside test only detects AcAc in blood and urine. This test is inconvenient, does not assess the best indicator of ketone body levels (3HB), provides only a semiquantitative assessment of ketone levels and is associated with false-positive results. Recently, inexpensive quantitative tests of 3HB levels have become available for use with small blood samples (5-25 microl). These tests offer new options for monitoring and treating diabetes and other states characterized by the abnormal metabolism of ketone bodies. Continue reading >>
Why Does Diabetes Cause Ketosis?
In diabetes due to the insulin deficiency there is increased hepatic gluconeogenesis and lipolysis And this lipolysis inturn increases free fatty acids. Now you know that as insulin is deficient in diabetes glucose cant be utilised as a energy source. So to get the energy an alternative source of these free fatty acids are used. End ketones being the end product of this fatty acid metabolism it gets accumulated. Initially it causes ketonemia(increased ketone bodies in blood) but this cycle keeps on going at ketoacidosis occurs. P.S- I just tried to simplify the answer,the exact mechanism is complex as there are lot of steps involved in it. Continue reading >>
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 a source of energy. When there is a limited supply of external energy sources, such as during prolonged fasting or carbohydrate restriction, ketone bodies can provide energy for most organs. In this situation, ketosis can be regarded as a reasonable, 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. What Is Ketosis? The human body can be regarded as a biologic machine. Machines need energy to operate. Some use gasoline, others use electricity, and some use other power resources. Glucose is the primary fuel for most cells and organs in the body. To obtain energy, cells must take up glucose from the blood. Once glucose enters the cells, a series of metabolic reactions break it down into carbon dioxide and water, releasing energy in the process. The body has an ability to store excess glucose in the form of glycogen. In this way, energy can be stored for later use. Glycogen consists of long chains of glucose molecules and is primarily found in the liver and skeletal muscle. Liver glycogen stores are used to mai 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 >>
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What Does Craig Good Think About The Ketogenic Diet?
It’s a fad - (It’s not - in actually got it’s first popularity in 1863.) It’s something you should only do under the care of a doctor People that write about it are nuts. I’m adding a personal anecdote to #2. See, I followed the recommendation of the American Diabetes Association (until 2008 they mentioned zero, nada about low carb diets.) My diabetes doctor sent me to a dietician who told me to eat a “low fat diet, and healthy whole grains.) I followed my doctor’s advice. The problem was that advice caused me to need to inject at least 60 units of insulin a day and still see fasting blood sugars in the 190 range. Only after starting a ketogenic diet could I start to see normal blood sugars while leaving insulin behind. Mr. BNBR says I shouldn’t say more than equate Mr. Good’s advice to the stuff we had to avoid when I marched in parades in college. Edited following response from the Quora messiah Craig Good Let me deal with Mr. Good’s insubstantial (but already upvoted answer.) It’s a starvation response NO NO NO. Think of how illogical this is. People are well fed, they have sufficient nutrition and all of the essential nutrients in their diets. Their bodies increase production of substances called ketones. Is this a starvation response? NO. Your body is producing ketones all the time. If you don’t eat overnight, your body is producing ketones. Everybody likely has some ketones in their bodies. The only “response” in the body is a shift from fueling things like the brain from reliance on glucose to reliance on ketones. What does happen is that insulin levels in the body fall and this triggers the body to start what would commonly be called “fat burning.” Since the body is not taking in glucose producing foods it switches it’s fuel fro Continue reading >>
What Are Ketone Bodies And Why Are They In The Body?
If you eat a calorie-restricted diet for several days, you will increase the breakdown of your fat stores. However, many of your tissues cannot convert these fatty acid products directly into ATP, or cellular energy. In addition, glucose is in limited supply and must be reserved for red blood cells -- which can only use glucose for energy -- and brain tissues, which prefer to use glucose. Therefore, your liver converts many of these fatty acids into ketone bodies, which circulate in the blood and provide a fuel source for your muscles, kidneys and brain. Video of the Day Low fuel levels in your body, such as during an overnight fast or while you are dieting, cause hormones to increase the breakdown of fatty acids from your stored fat tissue. These fatty acids travel to the liver, where enzymes break the fatty acids into ketone bodies. The ketone bodies are released into the bloodstream, where they travel to tissues that have the enzymes to metabolize ketone bodies, such as your muscle, brain, kidney and intestinal cells. The breakdown product of ketone bodies goes through a series of steps to form ATP. Conditions of Ketone Body Utilization Your liver will synthesize more ketone bodies for fuel whenever your blood fatty acid levels are elevated. This will happen in response to situations that promote low blood glucose, such as an overnight fast, prolonged calorie deficit, a high-fat and low-carbohydrate diet, or during prolonged low-intensity exercise. If you eat regular meals and do not typically engage in extremely long exercise sessions, the level of ketone bodies in your blood will be highest after an overnight fast. This level will drop when you eat breakfast and will remain low as long as you eat regular meals with moderate to high carbohydrate content. Ketone Bodi Continue reading >>
Your Brain On Ketones
The modern prescription of high carbohydrate, low fat diets and eating snacks between meals has coincided with an increase in obesity, diabetes, and and increase in the incidence of many mental health disorders, including depression, anxiety, and eating disorders. In addition, many of these disorders are striking the population at younger ages. While most people would agree that diet has a lot to do with the development of obesity and diabetes, many would disagree that what we eat has much to do with our mental health and outlook. I believe that what we eat has a lot to do with the health of our brains, though of course mental illness (like physical illness) has multifactorial causes, and by no means should we diminish the importance of addressing all the causes in each individual. But let's examine the opposite of the modern high carbohydrate, low fat, constant snacking lifestyle and how that might affect the brain. The opposite of a low fat, snacking lifestyle would be the lifestyle our ancestors lived for tens of thousands of generations, the lifestyle for which our brains are primarily evolved. It seems reasonable that we would have had extended periods without food, either because there was none available, or we were busy doing something else. Then we would follow that period with a filling meal of gathered plant and animal products, preferentially selecting the fat. During the day we might have eaten a piece of fruit, or greens, or a grub we dug up, but anything filling or high in calories (such as a starchy tuber) would have to be killed, butchered, and/or carefully prepared before eating. Fortunately, we have a terrific system of fuel for periods of fasting or low carbohydrate eating, our body (and brain) can readily shift from burning glucose to burning what ar Continue reading >>
By-products formed when the body breaks down fat for energy. When the body is starved of glucose or, as in the case of Type 1 diabetes, does not have enough insulin to use the glucose that is in the bloodstream, it begins breaking down fat reserves for energy. Unlike glucose, which “burns clean,” the breakdown of fat creates potentially toxic by-products called ketones, which accumulate in the blood. An excessive amount of ketones in the blood is called ketosis. When the kidneys filter ketones into the urine, the condition is called ketonuria and can be detected by urine ketone tests. If enough ketones accumulate in the blood, they can cause a potentially life-threatening chemical imbalance known as ketoacidosis. The symptoms of ketoacidosis include nausea, vomiting, tiredness, frequent urination, and a fruity odor to the breath. Anyone with symptoms of ketoacidosis should seek medical help immediately. Ketoacidosis is often what causes people to first be diagnosed with Type 1 diabetes: Beta cells in the pancreas stop making enough insulin, thus preventing body cells from getting energy in the form of glucose. The body responds by burning fats for fuel, creating an excess of ketones in the blood. As dehydration also sets in, the person develops ketoacidosis. The nausea and vomiting that accompany ketoacidosis are sometimes mistaken for the symptoms of a bad flu. People with diabetes, particularly those with Type 1 diabetes, are at increased risk of ketoacidosis when they are sick. The stress of illness tends to raise blood glucose levels. But since illness often decreases a person’s appetite, resulting in less food intake than usual, some people mistakenly decrease their insulin dosages. In fact, increased amounts of insulin are often needed when a person is sick. Continue reading >>
Keto Diet Science: How Your Body Burns Fat
By now, you’ve probably heard about the keto diet. You've probably heard that it all but bans carbs and sugars, or that it's been clinically shown to reduce epileptic seizures in kids, or even that it helps people condition their bodies to burn fat. As we detailed in our recent feature on the keto diet, all of those things are true. But as any bodybuilder knows, you don't need to be on the keto diet to burn fat. Heck, you can do it with a focused meal and exercise plan. So we've been wondering: When your body "burns fat" for energy, what's really going on there? How exactly does the keto diet work? And why the hell is it called the "keto" diet, anyway? Play Video Play Loaded: 0% Progress: 0% Remaining Time -0:00 This is a modal window. Foreground --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Opaque Background --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Transparent Transparent Window --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Transparent Transparent Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Default Monospace Serif Proportional Serif Monospace Sans-Serif Proportional Sans-Serif Casual Script Small Caps Defaults Done Well strap some protective boxing headgear over those thinking caps, bros, because we’re about to roundhouse kick you in the brain with some KNOWLEDGE. (For a detailed breakdown of the chemistry at work, be sure to check out our references: this explainer on ketone bodies from the University of Waterloo, and this ketosis explainer from Rose-Hulman Institute of Technology [PDF], plus our feature on the keto diet from the July/August issue of Men's Fitness.) Why does the body go into fat-burning mode? For most pe Continue reading >>