My sister in law has diabetes and when she was diagnosed she said her ketone levels were way high and that it wasn’t healthy. Now that I tell her about this diet and how people reverse their diabetes she doesn’t understand how it can be healthy to produce ketones when they were damaging her body at one point.
If anyone has any research or information about this it would help tremendously. I have been keto for almost 4 months and feel great but I’m not entirely informed about the diabetic side of it. Thanks for the help.
Edit - I didn’t think it was possible for T2 to be in true ketoacidosis. T2 produce too much insulin, which would definitely not produce ketones. Maybe the term they used “ketoacidosis” was some uninformed doctor?
It sounds as if she was no longer producing enough insulin (like a type 1). This would produce high levels of ketones and some other symptoms. It is often true that dehydration is part of that scenario.
We all produce ketones on some level through out life. We come into this world in ketosis and breastfeeding babies are in ketosis. We produce ketones as a source of energy naturally and not as a result of pathology. However some people have existing issues like insulin dependent diabetics that can allow ketones to get out of whack. They can still benefit from a ketogenic life style but will be managing diet and insulin differently then the average metabolically damaged person.
At the core of diabetic ketoacidosis (DKA) is insufficient quantities of insulin, not the ketones and not the sugar and not the acidemia - they are effects of the diminished insulin and indicators of how desperate the body has become for energy.
It’s a common belief that insulin transports energy into cells, but it’s actually glucose transporters (GLUT) and all but 2 require insulin to be present and the brain and heart have levels of the non-insulin GLUTs which is why people in DKA don’t immediately die without insulin.
It’s also not commonly known that even ketones require small amounts of insulin to enter cells.
At the time when insulin is extremely low, the vast majority of glucose can’t make it into any cells except for some in the brain and heart, but this is just enough to keep the person alive for a while, and I’m not aware of any backup pathways for ketones although they may exist.
The brain doesn’t have any mechanism for detecting hyperglycemia (only hypoglycemia) and just “knows” that there isn’t enough energy coming in, so it resorts to the only system for generating energy from bodyfat that provides something other than glucose and that’s ketones from ketogenesis.
In other words, at this point, the brain is trying to feed itself with ketones.
Unfortunately, even these ketones can’t make it into cells and the body gets caught in a cycle of generating more and more ketones in a desperate attempt to fuel the brain and body and without that insulin the ketones just get higher and higher to the point that their acidity affects the blood and produces acidemia.
DKA is the result of a desperate plea by the brain for energy in an attempt to fuel itself with ketones, but without any insulin or a mechanism to slow ketogenesis, the cycle spirals out of control.
Ketones are not dangerous, it’s the nearly non-existent levels of insulin that are dangerous that triggered the cycle in the first place.
To paraphrase Dr Attia, the difference between ketosis and ketoacidosis is the difference between a fire in a fireplace and a 4-alarm burning building. If your SiL is even remotely capable of distinguishing between those two, she can grasp the concepts of ketosis being physiologically normal. Whether she will is another issue.
They absolutely can!
It has happened to many I know. When a Type 2 diabetic gets very advanced in their disease, they stop producing insulin as well, and need to inject insulin just like a Type 1 diabetic!
Ketoacidosis is a very real risk to Type 2 diabetics
Who diagnosed her ketoacidosis? Something doesn’t add up to me. Some people think 3 millimoler is WAY HIGH as they aren’t up to date on the science of ketogenesis. It’s hard to say what’s going on with her without knowing what her figures were.
This happened a while ago and I’m not sure what the the ketone number was or who told her. But thank you everyone for explaining it and helping me understand the processes that cause this. I can go to her with this and let her know its perfectly safe for her to give keto a chance.
Hmmm… my understanding is that diabetic ketoacidosis is a medical emergency that you are taken to hospital for while vomitting, confused and with uncontrolled diarrhoea. So it would have been the ER doctor in admissions that diagnosed her. Did your sister mention a trip to the emergency ward?
It sounds to me like perhaps she just received a warning about it instead. Hard to say how relevant the warning is as some doctors warn everyone about LCHF regardless. Good luck with your sister. I love it when families care for each other.
Most traditional medical practitioners are never taught that there is any state of elevated ketones that is not DKA. They see elevated ketones and alarm bells ring. They’ve never been taught about nutritional ketosis and associate ketones with danger. Some are more enlightened, but you never know who is and who isn’t.
Even if you google ‘ketosis’, you are like as not going to run across the definition for DKA instead. It’s going to take some time, which is frustrating because I remember these conversations back in the late 90’s and articles explaining the difference. I wasn’t even doing Atkins and I heard and understood that ketosis and ketoacidosis were not even close to the same thing. smh
I don’t want this to hijaak the thread, but not only are most traditional medical practitioners not aware of nutritional ketosis, but if they’ve heard of a “ketogenic diet”, they think of the extremely harsh version that’s prescribed for refractory epilepsy such as might occur on a rotation through neurology.
She was in the emergency room and they were trying to figure out what was happening and why she was so sick and trying pinpoint the problem until they found out she was type 2.
Good lord, that certainly sounds like DKA. So she was diagnosed type 2 in the emergency ward during her DKA? Wow! Does she remember what she ate at the time? Or was the episode before eating? Or some other lifestyle trigger?
I’m sure there’s someone here in the forum who’s got a similar circumstance to your sister… now hmmm, how to find them.
