Diabetes, Ketoacidosis, and The Ketogenic Diet: What You Need To Know

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If you have diabetes, you should be aware of the dangers of diabetic ketoacidosis (DKA). (If not, learn more here.) DKA is often the reason for an initial type 1 diagnosis, and it’s is the most common cause of death among young people with diabetes. All people with diabetes can experience DKA, but it’s much more common in those with type 1.

DKA is caused by a buildup of ketones in the blood, causing the blood to become acidic and toxic to the body. DKA can cause confusion, vomiting, difficulty breathing, and, if not treated, death.

So then why would anyone want to purposely trigger ketones using a ketogenic diet? Let’s take a look:

What are ketones?

When your body is not able to get enough glucose for fuel, it starts to burn fat. The liver breaks down fatty acids and sends ketones in the blood to be used for energy. Ketones are produced whenever fat is burned, and it’s perfectly normal to have a low level of ketones in the blood.

Your body usually burns both fat and glucose (carbohydrates) in different ratios depending on how hard you are working. When someone start to burn a much larger ratio of fat and carbs than usual, they can go into ketosis. Ketosis can be caused by an eating disorder, fasting, or by following a strict ketogenic diet.

Photo: AdobeStock/Daniel Vincek

Photo: AdobeStock/Daniel Vincek

Is the Ketogenic diet safe?

The ketogenic diet severely restricts carbs so that the body eventually goes into ketosis and starts to lose fat (and muscle). Ketogenic diets cause fast weight loss and can reduce blood pressure and triglycerides. While there is some concern about the safety of going into ketosis, it is generally safe for those without diabetes.

However, for those with diabetes, lack of insulin means that the body will continue to produce ketones because the insulin can’t tell the fat cells to stop releasing fatty acids. More and more ketones enter the blood and the acidity causes ketoacidosis.

While ketosis is in a sense the beginning stage of ketoacidosis, full-blown DKA requires a much higher level of ketones. But a person without diabetes will have natural insulin to regulate blood sugar and keep the body from overproducing ketones. But without insulin, the body will think that it’s starving and continue producing ketones at a dangerous rate.

Can someone with diabetes go on a ketogenic diet?

A person with type 1 diabetes, or severe type 2, should talk to their doctor before starting a ketogenic diet. A diet low in carbohydrates may be helpful in that the body requires less insulin and burns more fat, but there are side effects when your body goes into ketosis, usually referred to as “keto-flu” that may last several weeks, and the strictness of the ketogenic diet may not be sustainable.

It may be wisest, and easiest, to focus on the tried-and-true advice of focusing on fruits, vegetables, whole grains, and lean protein. Try these simple guidelines offered by the American Diabetes Association.

Ketones, like many things, are not dangerous at low levels. But for someone with diabetes, they can be deadly, and it’s heartbreaking that we still lose people to DKA every year. Whatever eating plan you choose, be sure to check your glucose levels regularly and check for ketones if you are experiencing symptoms. Stay healthy, friends!

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Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.
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