Nutritional Ketosis Vs. Diabetic Ketoacidosis (DKA)

There are some medical professionals that still are perplexed when it comes to ketosis. These same doctors may tell their patients that a Ketogenic diet is not good for you.

They usually confuse ketosis, which is a normal benign condition associated with fasting or keto dieting, with ketoacidosis, a life threatening unhealthy condition.

What is a Ketogenic Diet?

A Ketogenic Diet (keto) restricts carbohydrates to about 2% to 5% of the total calorie intake. In comparison, the typical Standard American Diet (SAD) is heavy on carbs. A SAD diet is typically made up of 50% to 65% carbohydrate calorie intake.

Using the keto formula, ketosis naturally occurs. There is also strong evidence that this low carb, high fat diet has a myriad of health benefits.

A keto dieter depends on a high content of natural fats to create a state of “nutritional ketosis”. This is a metabolic process that speeds up weight loss by more quickly burning fat by producing ketones.

What are ketones and ketone testing?

Ketone bodies are a vital part of the ketosis process. Ketones are the natural result when the body burns fat.

Ketones occur during times when very little food is being consumed. They are created from fatty acids in the liver.

Under certain circumstances ketones are the body’s normal response to the process of breaking down fat for energy. During weight loss or whenever there is not enough insulin to use blood sugar (glucose) for energy, ketones develop.

People with diabetes monitor their ketone levels. Home testing strips for urine can be used. A more accurate tool is a blood ketone meter.

During nutritional ketosis adults who have a working pancreas don’t get above 8-10 mmol/l and usually average in the 1-3 mmol/l range.

An individual with a DKA reaction would have ketones exceeding 20 mmol/l.

For a diabetic, the detection of ketones in their urine is a warning sign. A large quantity of ketones (around 20 mmol/l ) is associated with diabetic ketoacidosis.

Nutritional Ketosis

The low carb ketogenic diet produces ketones and reduces blood sugar and insulin levels. They remain in the safe range (not to exceed 8-10 mmol/l). As the glucose and insulin levels in the blood drop and ketones appear, heart, muscle and brain automatically cut back on glucose in order to rely on fats to burn.

By creating the metabolic process of nutritional ketosis the keto diet creates a literal fat burning machine.

This happens naturally when you reduce carbohydrate intake to below 50 grams. At that time the food that’s consumed produces less glucose, but blood sugars remain stable in a healthy range, the body starts to burn body fat for energy and fuel. A signal of this process is the appearance of ketones in safe levels in the blood and urine.

Nutritional ketosis that occurs when you are on a ketogenic diet is not dangerous. The PH levels remain within safe ranges and there is a balanced level of insulin to regulate the process.

Nutritional Ketosis occurs naturally when:

it has been a long time since you’ve eaten and the body burns fat for fuel producing very low-levels of ketones
newborn babies are in nutritional ketosis at birth until their mom’s breast milk begins better production

Most people benefit from the state of ketosis. It is just a benign process kicked off by a keto diet that gets your own body to burn unnecessary fat.

Ketosis is not recommended for people with untreated diabetes or active alcoholism. Any nutritional program should be monitored by a medical professional if you have these pre-existing conditions.

Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis (DKA) is triggered when a diabetic (usually type 1) goes without treating their disease. When the blood glucose level gets ramped up far above a normal range DKA can result.

DKA should not be confused with nutritional ketosis. Ketosis does not cause ketoacidosis.

Ketogenic acidosis can occur:

If a type 1 diabetic does not inject enough insulin. This usually happens during a time that they are sick or injured.
If a type 1 diabetic has not yet been diagnosed or treated DKA may be the condition that reveals their diagnosis.
During long periods of starvation (typically months)
During long periods of alcohol abuse (also known as alcoholic ketoacidosis)

Treatment for Diabetic Ketoacidosis

If you do suspect that you or someone else is suffering from this dangerous condition, get immediate medical attention. Go to an emergency room or hospital.

If left without treatment diabetic ketoacidosis can be life threatening.

Typically the medical treatment for Diabetic Ketoacidosis is:

Replace fluids. Severe dehydration is dangerous for anyone. It can be life threatening for diabetics, especially severe or uncontrolled diabetics who are at risk of ketoacidosis.
Replace and replenish electrolytes. When insulin levels are low it affects electrolytes. Electrolytes are much needed minerals (potassium, chloride and sodium). By giving the diabetic electrolytes a balance can be immediately restored.
Insulin to restore blood sugar levels. In diabetes it’s important to keep blood sugar levels in check. In a ketoacidosis emergency insulin therapy may be given through an IV (intravenously). When the diabetic is stabilized they can return to their normal insulin regimen.

Why is Ketosis Beneficial?

In addition to the obvious weight loss benefits ketosis brought on by a keto diet can have additional benefits. Early research pointed to the dramatic positive effect that ketosis brought on by a ketogenic diet can have on epilepsy.

In the last two decades a myriad of medical research has revealed how low carbohydrate diets can have a beneficial impact on brain disorders, heart disease, high blood pressure, high cholesterol, triglyceride issues and of course epilepsy.

Even in diabetes management (under a doctor’s care), if a normal range of insulin is maintained nutritional ketosis is not dangerous. When a diabetic has their blood sugars stable, ketosis may be beneficial.

Nutritional ketosis associated the ketogenic diet is not dangerous, at all. It may even have some very positive results on certain diseases and health conditions.