21/07/2022
Difference between diabetic ketoacidosis(DKA) and nutritional ketosis
First, what are Ketones?
Ketones are naturally occurring fatty acids produced in the body. Why does the body need ketones? The body cannot store glucose for more than 24 hours, which is why it is essential to maintain glucose levels for energy. And of course, this is also why humans must consume various foods to maintain the levels. In particular, the human brain (and other cells in the body) functions with the help of glucose and ketones. If there is not sufficient glucose, then the liver takes fat and certain amino acids (called fatty-acid metabolism) and turns them into ketones, first to feed the brain, then the rest of the body. This is called keto-adaptation, or nutritional ketosis, and is thought to be an evolutionary adaptation.
The liver typically produces ketones, and they will be completely metabolized, so there will be few, if any, that appear in a person’s urine. Normally, 3 to 15 milligrams of ketones (a minimal amount) are excreted in the urine daily.
Diabetic ketoacidosis can occur when a person with diabetes has an episode of extremely high blood glucose and elevated levels of ketone. Diabetic ketoacidosis (DKA) occurs when a person with diabetes does not receive enough insulin. Without the insulin to help get the glucose into the body’s cells, the liver starts making ketones out of fat and proteins to give the body’s cells energy, especially in the brain. But because there is no insulin, the cycle continues, and more ketones are produced. Both glucose and ketones are then transferred to the urine.
The kidneys begin emptying the bloodstream of excess glucose and ketones with water, causing the person to urinate more and become dehydrated. By the time ketones reach around 15 to 25 mM (millimolars), the body’s resulting pH balance leads to metabolic problems, and the person becomes very ill. The metabolic disturbance usually causes low blood pressure and shock, and if not treated, the process can lead to a coma and eventual death.
In nutritional ketosis, the body normally produces a small amount of ketones every day when it burns fat for energy or fuel, for example, when a person loses weight or fasts. This is when the liver metabolizes fatty acids, turning them into ketones that are used as energy in various parts of the body.
People with diabetes must be careful not to confuse normal ketosis with diabetic ketoacidosis—the first is usually something to be watched, while diabetic ketoacidosis is often a medical emergency. In a person with diabetes, diabetic ketoacidosis means the blood glucose levels are high (hyperglycemia), the person has low insulin levels, and there are moderate to large amounts of ketones in the blood.
What should you do if you test positive for ketones?
High ketone numbers may mean you need additional insulin. It would help if you also drank plenty of water and other fluids (that contain no calories) to flush out the ketones from the blood. You must continue checking your blood glucose levels for three to four hours, testing for ketones if the blood glucose level is consistently over 13.8 Mmol/l and ketones present, you should not exercise because it can lead to DKA, and it is advised you visit a medical center asap