Ketosis vs. Diabetic Ketoacidosis

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You have probably heard of the dangers of a low carb diet by now. You don’t need to google far to be warned of it’s complications. One critic to the low carb diet, is the dangers of diabetic ketoacidosis. Unfortunately many sources mistake ketosis for ketoacidosis. These two terms are erroneously intermixed. Ketosis is the bodies ability to effectively metabolize fat into ketones to be used as fuel by the working cells. While in diabetic ketoacidosis, insulin fails to reach working cells inhibiting glucose from entering. This diabetic then enters into starvation and as tries to break down ketones for fuel. This diabetic has no insulin however to allow the ketones to enter the cell. The ketones build up causing an extremely acidic environment where proteins denature and ultimately death ensues. This amount of ketone production is not possible for those with functioning pancreatic cells and insulin responses. Even the slightest insulin response will cause a halt to lowering acidity levels.

Let’s look at some graphs provide by Dr. Attia of Eating Academy.

This graph shows the advantage of ketosis when glucose stores are unavailable. The ketone, B -hydroxybutyrate, is able to compensate for the lack of glucose as glucose eventually stabilizes. (For more information on this study click here)

Our brains are built to be fueled by glucose and ketones and nothing else. And because the typical human can only store 24 hours worth of glucose, ketones allow a spare reserve when glucose isn’t available. Where do these ketones come from? Ketones are produced by the liver from fat (and some proteins) and allow our brains to function in the absence of glucose. When ketones are released the pancreas is signaled to release insulin to encourage ketone and glucose uptake by working cells. In ketoacidosis however there is no insulin released and so ketones continue to build up in the blood stream. The insulin feedback loop is broken so the cells believe they are starving and continuously break down more fat/protein with no cell uptake.

Here is a visual for the ketoacidosis feedback loop:

References:

Attia, Peter, M.D. “Blog – The Eating Academy | Peter Attia, M.D.” TheEatingAcademy.com. The Eating Academy, 26 Nov. 2013. Web. 13 Mar. 2014.

“The Difference between Ketosis & Ketoacidosis?” Diabetes Daily RSS. N.p., n.d. Web. 13 Mar. 2014.

O’neille, Michael. “Ketosis: Fear, Uncertainty and Doubt | KetopiaKetopia.” Ketopia. N.p., n.d. Web. 13 Mar. 2014.

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