Ketosis vs. ketoacidosis - the major differences

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Ketosis vs. ketoacidosis - the major differences


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Old 08-29-2012, 05:22   #1
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Default Ketosis vs. ketoacidosis - the major differences

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Originally Posted by optimist View Post
I`m type 1, I use only 12 units of Lantus a day, have an A1c that is 5,5 and eat LCHF (maximum 5 carbs for each meal)
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Do you have any problems with Ketosis, well ketoacidosis? From what I've read, ketosis isn't normally a problem for healthy people because insulin helps to regulate it. But if you are Type 1 then how is your insulin regulating ketosis?

I'm asking because I'm pretty sure I'm LADA and I've been having to cut back more and more on carbs to maintain my BG levels. I'm a bit concerned what will happen if/when I stop producing insulin.

 
Old 08-29-2012, 06:16   #2
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Ketosis and ketoacidosis are different animals, although ketones are central to both.

Ketosis is simply the process of fueling our bodies with ketones instead of glucose. This is accomplished by sharply reducing carb intake, and allowing our metabolism to accomodate - switching over to running on ketones. This removes the glucose issues from diabetes, and what few body functions require glucose (5%), gluconeogenesis can cover by creating glucose from the protein we eat.

Ketoacidosis is the absence of insulin in the presence of glucose. When there is no insulin available (as is sometimes the case of type 1 diabetics - even, as you say, LADA, and occasionally type 2), glucose begins to build up and blood sugar levels skyrocket. So the simple scenario is that having ketones along with high blood sugar is the recipe for disaster and destruction. Regular frequent testing is the solution to this - keep your meter handy.

If you reach the point where you have insufficient production of endogenous insulin, then you will need to begin using exogenous insulin. But even that doesn't necessarily preclude using ketosis as a management tool.




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Old 08-29-2012, 11:57   #3
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I`m eating ketogenic, and each time they test my urine I have ketones there, but that is not dangerous at all. It just show that my body has learned to use fat instead of carbohydrates as its fuel.

I never have had any ketoacidosis. Ketoacidosis is caused by high BG, and living LCHF gives me a very good control over my BG so the numbers I saw in the beginning of the illness, is long time history.

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Old 08-29-2012, 18:06   #4
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Ketoacidosis is the absence of insulin in the presence of glucose. When there is no insulin available (as is sometimes the case of type 1 diabetics - even, as you say, LADA, and occasionally type 2), glucose begins to build up and blood sugar levels skyrocket.
Pretty sure you are wrong about that. Ketoacidosis is defined as having excessively high ketones. This can be "caused" by high glucose levels in the absence of insulin, but it can also be caused by other things.

Even normal healthy individuals can sometimes go into ketoacidosis during prolonged fasting. Obviously if they are fasting then they aren't going to have high glucose levels

I'm not an expert but my understanding is that insulin somehow regulates ketone production. However, I haven't found anything that really explains this so I'm somewhat concerned about intentionally going into ketosis without sufficient insulin to control it.
If the basal insulin injections that T1s use are sufficient to control ketosis, then it's probably not an issue. However, I still have not found anything that explains this.

 
Old 08-29-2012, 18:08   #5
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Quote:
Originally Posted by optimist View Post
I`m eating ketogenic, and each time they test my urine I have ketones there, but that is not dangerous at all. It just show that my body has learned to use fat instead of carbohydrates as its fuel.

I never have had any ketoacidosis. Ketoacidosis is caused by high BG, and living LCHF gives me a very good control over my BG so the numbers I saw in the beginning of the illness, is long time history.
Well that's good news, thank you.

Can you provide some information about your insulin regiment?

 
Old 08-29-2012, 18:35   #6
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Quote:
Originally Posted by Peter_V View Post
Pretty sure you are wrong about that. Ketoacidosis is defined as having excessively high ketones. This can be "caused" by high glucose levels in the absence of insulin, but it can also be caused by other things.
Shanny is correct

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Originally Posted by Peter_V View Post
high I'm not an expert but my understanding is that insulin somehow regulates ketone production.
Ketosis is not regulated by insulin.

Ketogenic Diet Resource
Within this site is a good (scientific) explanation of what ketosis is.

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Old 08-29-2012, 19:19   #7
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In The Art and Science of Low Carbohydrate Living (pg 80) they define diabetic ketoacidosis as a state where "...the pancreas can no longer produce the minimal amount of insulin required to limit fatty acid release from the body's fat cells." "When fat cells release fatty acids too rapidly, ketone production becomes imbalanced..."

So not only is the insulin not keeping one's blood sugar under control, there isn't enough to prevent your fat cells from dumping their contents and driving your ketones sky high.

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Old 08-29-2012, 19:26   #8
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Quote:
Originally Posted by Peter_V View Post
Pretty sure you are wrong about that. Ketoacidosis is defined as having excessively high ketones.
You'll need to provide a citation for this, Peter; a definition of diabetic ketoacidosis. I stand by my original explanation.




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Old 08-29-2012, 19:50   #9
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Ketoacidosis is defined as having excessively high ketones. Thats true, my endo told me if I have too high BG, the sugar in my blood would become acid and I would have ketoacidosis, which can be life-treatening.

When you eat ketogenic, you will come in ketose, but this is completely something else.
Its correct there will be ketons in the urine, but in small amount. Each time I see my endo she tests my urine, and there is 2-3 ketons pr ml., which is quite normal as long as the body use fat as the fuel, and it is not dangerous at all.

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Old 08-29-2012, 20:13   #10
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You have to think about DKA Diabetic Ketoacidosis as your body starving because its lacks sufficient insulin to unlock the cells to let glucose in as an energy source. When this happens your body refuses to lie down with out a fight so it turns to lipids and starts to break them down to use as fuel. Now you have a scenario where you have extremely high BG level, lack of insulin, and your bodies producing ketones to fuel your cells. This leads to an acidic condition in your blood stream, well you know the rest.

Dietary ketosis occurs when you restrict the amount of carbs (glucose) to your cells, the cells then again revert to burning lipids, sending the by products to your liver to convert to ketones to fuel other parts of your body. Dietary ketosis differs from DKA in that your BG level is with in normal range and you do not require as much insulin to maintain this state of being. Dietary ketosis is perfectly safe and has been practiced for centuries.

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