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Ketosis is a normal metabolic process. When the body does not have enough glucose
for energy, it burns stored fats instead; this results in a build-up of acids called ketones
within the body.
Some people encourage ketosis by following a diet called the ketogenic or low-carb
diet. The aim of the diet is to try and burn unwanted fat by forcing the body to rely on
fat for energy, rather than carbohydrates.
Ketosis is also commonly observed in patients with diabetes, as the process can occur
if the body does not have enough insulin or is not using insulin correctly.
Problems associated with extreme levels of ketosis are more likely to develop in
patients with type 1 diabetes compared with type 2 diabetespatients.
Ketosis describes a condition where fat stores are broken down to produce energy,
which also produces ketones, a type of acid.
As ketone levels rise, the acidity of the blood also increases, leading to
ketoacidosis, a serious condition that can prove fatal.
People with type 1 diabetes are more likely to develop ketoacidosis, for which
emergency medical treatment is required to avoid or treat diabetic coma.
Some people follow a ketogenic (low-carb) diet to try to lose weight by forcing the
body to burn fat stores.
What is ketosis?
In normal circumstances, the body's cells use glucose as their primary form of energy.
Glucose is typically derived from dietary carbohydrates, including:
If there is not enough glucose available to meet energy demands, the body will adopt
an alternative strategy in order to meet those needs. Specifically, the body begins to
break down fat stores to provide glucose from triglycerides.
Ketones are acids that build up in the blood and are eliminated in urine. In small
amounts, they serve to indicate that the body is breaking down fat, but high levels of
ketones can poison the body, leading to a process called ketoacidosis.
Ketosis describes the metabolic state whereby the body converts fat stores into energy,
releasing ketones in the process.
Due to the fact that ketosis breaks down fat stored within the body, some diets aim to
create this metabolic state so as to facilitate weight loss.
ketogenic diets
keto diets
low-carbohydrate diets
The diet itself can be regarded as a high-fat diet, with around 75 percent
of calories derived from fats. In contrast, around 20 percent and 5 percent of calories
are gained from proteins and carbohydrates, respectively.
Adhering to the ketogenic diet can lead to short-term weight loss. A study conducted
in 2008 and published in the American Journal of Clinical Nutrition found that obese
men following a ketogenic diet for 4 weeks lost an average of 12 pounds during this
time.
The participants were able to consume fewer calories without feeling hungry while
following the diet.
Is ketosis healthy?
The ketogenic diet could have a healthful effect on serious health conditions such as:
cardiovascular disease
diabetes
metabolic syndrome
It may also improve levels of HDL cholesterol (high-density lipoproteins, also known
as "good" cholesterol) better than other moderate carbohydrate diets.
These health benefits could be due to the loss of excess weight and eating of healthier
foods, rather than a reduction in carbohydrates.
The ketogenic diet has also been used under medical supervision to reduce seizures in
children with epilepsy who do not respond to other forms of treatment. Some studies
have suggested that the diet could also benefit adults with epilepsy, although more
research is required to confirm these findings.
However, longer-term adherence to the ketogenic diet does not appear to yield great
benefit.
The American Heart Association (AHA), American College of Cardiology, and the
Obesity Society have concluded that there is not enough evidence to suggest that low-
carbohydrate diets such as the ketogenic diet provide health benefits to the heart.
Other conditions are also being studied to see if a ketogenic diet might be beneficial;
these include:
metabolic syndrome
Alzheimer's disease
acne
cancer
Some dietitians recommend a ketogenic diet for individuals with type 2 diabetes, also
known as non-insulin dependent diabetes (NIDDM). With type 2 diabetes, the body
still produces some insulin but is unable to properly use the insulin to transport
glucose into cells for use as fuel.
The ketogenic diet focuses on the reduction of dietary carbohydrate intake. Individuals
with type 2 diabetes are recommended to reduce carbohydrate intake as carbohydrates
are converted to glucose and increase blood sugar levels.
Patients with diabetes who follow a ketogenic diet need to carefully monitor their
ketone levels. A serious condition called ketoacidosis can occur if these levels get too
high, and although it is most prevalent in individuals with type 1 diabetes, people with
type 2 diabetes can also develop ketoacidosis.
Ketoacidosis
Ketoacidosis is a condition where the levels of ketones in the body are abnormally
high, poisoning the body. It is a serious and dangerous condition that can quickly
develop, sometimes within the space of 24 hours.
There are several different potential triggers for ketoacidosis. It is most commonly
caused by illnesses that lead to the production of higher levels of hormones that work
against insulin.
It can also result from problems with insulin therapy, either through missing scheduled
treatments or not being given enough insulin. Less common triggers of ketoacidosis
include:
drug abuse
emotional trauma
physical trauma
stress
surgery
Ketoacidosis most commonly occurs in people with type 1 diabetes due to the body
not producing any insulin. Ketoacidosis can also occur in people with type 2 diabetes,
although it is much less common.
High levels of ketones in the urine and high blood sugar levels (hyperglycemia) are
signs of ketoacidosis and can be detected with kits in the home.
abdominal pain
fruity breath
frequent urination
Ketone levels can be monitored using urine testing kits that are commonly available over the counter.
Ketosis does not usually occur in healthy individuals that eat balanced diets and
regular meals. Drastically reducing the amount of calories and carbohydrates that are
consumed, exercising for extended periods of time, or being pregnant can all trigger
ketosis.
In patients with diabetes, ketosis and eventually ketoacidosis may occur if insufficient
insulin is used to properly manage the condition, if meals are skipped, or if an insulin
reaction occurs (often while asleep).
Fluid replacement - to rehydrate the body and dilute the excess sugar in the blood.
Electrolyte replacement - these are needed to help keep the heart, muscles, and
nerve cells functioning correctly. Levels in the blood often drop in the absence of
insulin.
Insulin therapy - to reverse the processes that caused the episode of ketoacidosis.
Among otherwise healthy people, following a healthy, balanced diet and exercising
regularly can prevent ketosis.
In addition, there are a number of measures that people with diabetes can take to help
prevent ketoacidosis:
Monitor blood sugar levels carefully and frequently - at least three to four times a
day.
Discuss insulin dosage with a specialist and follow a diabetes treatment plan.
Keep an eye on ketone levels with a test kit, particularly when ill or under stress.