Ketogenic Diet and Ketoacidosis
Keto Diet

New Research: Ketogenic Diet and Ketoacidosis

The ketogenic diet is a new diet popular among fat loss and fitness individuals that centers on reducing carbohydrates and increasing fat intake to burn body fat. Diabetic ketoacidosis (DKA), along with diabetic hyperosmolar state (HHS), is known as the hyperglycemic crisis of diabetes. About 30% of people with diabetes have both DKA and HHS states.

What is Ketoacidosis?

When there is insufficient insulin or a lack of sugar in the body and excess fat is broken down, the concentration of ketone bodies increases and some of them can be excreted through the urine, forming ketonuria. When the amount of ketone bodies produced by the liver exceeds the capacity of extrahepatic tissues to utilize them, the concentration of ketone bodies in the blood will be too high, leading to ketonemia and ketonuria. Both acetoacetic acid and β-hydroxybutyric acid in ketone bodies are acidic, and when they accumulate in the blood in excess, they will make the blood acidic and cause acidosis, called ketoacidosis.

What is Nutritional Ketosis?

It is the progressive process of the ketogenic diet and the state we commonly refer to as a person on a ketogenic diet. In a state of normal insulin regulation, it is a controlled process in which the body produces ketone bodies by burning fat in moderation. The ketogenic diet was originally invented to treat epilepsy.

Difference Between Nutritional Ketosis & Ketoacidosis

The Difference Between Nutritional Ketosis & Ketoacidosis

Both nutritional ketosis and ketoacidosis involve the production of ketone bodies. However, nutritional ketogenesis is not ketoacidosis, and the main difference between the two is the number of ketone bodies produced.

Nutritional ketosis. This is the state in which people on what is commonly referred to as a ketogenic diet find themselves. The purpose of a ketogenic diet is to induce “ketosis,” which is a high-fat, very low-carbohydrate diet. On a ketogenic diet, your entire body relies almost entirely on fat burning to keep it functioning.

Ketoacidosis is a serious pathological state in which, when the body lacks insulin, blood sugar spikes and large amounts of fat are broken down, resulting in the uncontrolled production of large amounts of ketone bodies that overwhelm the delicate acid-base balance in the blood. This results in an acidic pH level of the blood in the body, which leads to extremely dangerous consequences. This is usually a complication of type 1 diabetes.

When nutritional ketosis occurs, the body uses fats instead of glucose as fuel. The liver separates these fats into chemicals called “ketones” and releases them into the bloodstream. This allows the body to use “ketone bodies” as a source of energy.

The ketogenic diet is designed to induce nutritional ketosis, which is achieved by eating foods that are high in fat but low in carbohydrates. The classic “ketogenic diet” consists of 3-4 grams of fat for every 1 gram of carbohydrate and protein consumed. According to the Epilepsy Foundation, studies have shown that more than 50% of children who try this diet have half or fewer seizures, and 10-15% have no seizures.

Research suggests that this diet may also help with some other neurological disorders, such as Parkinson’s disease and Alzheimer’s disease. Conversely, ketoacidosis occurs when the body begins to break down fat and protein rapidly. If a person does not have enough insulin, the body cannot transfer glucose from the blood to the cells, which eventually leads to, high levels of blood sugar and ketone bodies accumulating in the bloodstream, which can be life-threatening in severe cases.

Symptoms of Ketoacidosis

  • Increased symptoms of diabetes
  • Increased levels of ketone bodies in the urine
  • Fatigue and exhaustion
  • Dehydration with symptoms of shock
  • Nausea and vomiting
  • Difficulty breathing
  • The fruity smell on the breath (similar to the smell of rotten apples)

In addition to the predisposition of diabetic patients to ketoacidosis, several other factors may contribute: for example, prolonged fasting, hyperthyroidism, alcoholism (this condition is alcoholic ketoacidosis), etc.


Whether you are on a ketogenic diet or diabetic, the easiest and most brutal way to know your blood glucose and blood ketone levels is to monitor them. In the ketogenic state, unused ketones are excreted or released through certain channels, such as breath, urine, and blood. The two methods we commonly use are urine tests and blood tests. For diabetics who need to know their blood glucose and blood ketone levels, the most convenient and simple way is to strictly monitor blood glucose and blood ketones using a blood glucose meter.