[Skybird]

Originally Posted by mapuc

I'm also suffering from Diabetic 2 and I have seen the word
diabetic ketoacidosis.

In a KETO-Diet your body enter this Ketosis.

Is Ketosis the same as Ketoacidosis ?

No! Not by a huge margin! Lets go through it in the right order, since many people over and over again mistake these two things.

First things first. As a late fetus, baby, child in the first years of its life, we are in ketosis, as long as we do not get put on carbohydrates. Ketosis is our most natural and our first energetic metabolic state, our bodies must not learn it as an adult, it just needs to remember it. Ketosis means our body "refines" fats in the liver and forms ketone bodies or ketones, these are the carriers of the needed energy that get shuttled around in the body and used in place of glucose/glucagon. When we get no longer mothermilk, but get taught to eat fruits and veggies and cereals, our body switches to glucose as its primary energy source, and it does so easily, unfortunately. Glucose gets further "refined" in Glucagon, which is stored and used as needed. It takes time to form glucagon, like it does take time to form ketones, but ketone-production nevertheless is faster in a system in ketosis. And since all your body fat serves as an energy reserve, if need be, you have 12-15 times more energy available, potentially, than you have energy in form of glucagon. Thats why it is much harder for you to tire out while being in ketosis, than if you were in a state of glucose-based energy production. Glucagon reserves get eaten up quickly and then take long time to refill, but since only rarely they get depleted (since we do not hunt, fight, run and survival that much anymore), our body prefers to make body energy from Glucose, its easier, less complex. Fat-metabolism on the other hand means you have a much longer reach in physical stamina/duration, and you do not have all the negative side effects of a carbohydrate-based metabolism. The body makes the very little glucose it indeed needs itself, there is non reason to fill glucose in from outside via food. Glucose energy cycle is a backup system for times of need and emergency, when meat and fish and fats from animals are not available, but it comes at a price. It should not be our normal standard energy production mode. Ketosis should be. We are designed to be ketogenic. The lion'S share if not all of modern civilizational diseases comes from us insisting that we know better than millions of years of evolutionary biological development and that we should make the backup system our primary operational mode - while the primary one nevertheless is absolutely functional and unbroken. The seocndary system is not mean to do the long run, it is meant to step in as a temporary fix and improvised solution, to be switched off again once the primary system is back on duty. It also helps to stgore some reserves inanutumn, when we sneak throguzn theb forest and occaisoanlly may stumble over a handful of soar wild berries with some carbs in them. There glucise gets stored in the fat cells sicne we are in ketosis, and form there they add to our chance that we survive winter. Isn't it wonderful how everything in nature falls into its right place - if only you let it?!

Now, ketoacedosis. Thats a state that mostly is found in type 1 diabetics, can also be triggered by alcohol abuse, could show up in pregnancy, or as a result from using certain medications.

The problem is the low supply in insulin, may it be that the pancreas does not make enough insuline, may it be that the artifical supply via syringe is dosed too low. This state triggers a sudden overreduction of fat in the fat reseves, and the liver gets practically overflooded with fat. It then creates ketones like crazy, but there is a problem in this specific situation: since there is no insuline in the blood, there is plenty of sugar in the blood. And this prevents that the ketones can get burned in the mitochondria inside the cells. The raising levels of unused ketones make the blood more acidic.

In healthy people, a too huge rise in ketone production can trigger a mild insuline reaction (where consumming fat in normal ammounts does not do that). You have a feedback mechanism here that serves the purpose of a security valve. In diabetics, this obviously can fail, they have no or too low insuline reactions already at the beginning of this process, and wont make any more insuline. I dont know for certain, but I would assume that as long as he does not need to take insulin, even a type 2 diabetic still is relatively safe. And even if he must take it, the better chances are that ketoacidosis does not become a problem. It happens. But not to most of those likely candidates.

Since ketones raise the pH level of the blood and make it more acidic, this is dangerous since the ph-level of blood must remain within extremely tight upper and lower levels, I think it was between 7.35 and 7.45 pH. In a ketoacedosis, ketones in the blood reach levels of 15+ mmol/l, which is very much, and dangerous, such acidic blood will practically always cause the person feeling very ill - you really will feel it if you are in a ketoacidosis! Normal levels of ketones in the blood of people in a solid good state of healthy ketosis are 5-7 mmol/l. Many people report even levels of just 2-4 mmol/l when being in ketosis.

Test strips for ketones where you pee on them and then read a colour grade against a scale and can estimate your ketone numbers this way, are primarily meant for diabetics right to test for their risk to approach a state of ketoacedosis. You cna fereely buy them at for exmaple Amazon. For normal people on a ketogenic diet, they only make sense at the beginning of their journey, since the more their body is remembering how to use ketones for energy needs, the less it is willing to excrete ketones with the urine anymore. So they may be in a deep and solid ketosis, but find that over time the test strip says that their number of ketones in the urine is dropping. Quite some confusion can come from this! If you want to monitor your kjetones, you need to scan your blood. There are small devices like those used for measuring sugar in the blood, you need a drop of blood, put it into the sensor, and read the number. 30-40 Euros. There are even such devices that allow both ketone and blood sugar measurment.

I would say that for both type 1 and 2 diabetics, carbohadrate avoiding diet is the diet of choice, may it be ketogenic, may it be carnivore, or whatever. Leave out those carbs, also in cereals. Cereals are not healthy, cereals ARE carbs! Sugar, that means. Almost completely.

A state of ketoacedosis is utmost dangerous and life threatening, immediate emergency care by a doctor or hospital crew is absolutely necessary.

So, Markus, if you fear your health problems are due to a creeping-in ketoacedosis, I think I am on the safe side when I tell you: you must not worry. First, you are type 2 and not type 1 diabetic, and second, if you were in a ketoacedosis all these days and no doctor treating it (those you met recently obviously also did not recognise it), you most likely by now would already be dead. I see even less risk for you if you, as a Diabetic type 2, also must not yet take insulin.