Uncontrolled diabetes has acute complications such as:
♦ Hyperosmolar hyperglycemic state
♦ Diabetic ketoacidosis
♦ Death
Following a healthy diet, low-fat diet, low-calorie diet, low carbohydrate diet, paleo diet, raw foodism, and the keto diet are the ways that diabetic patients can choose to prevent, manage and control their disease.
The low-carb diet contains up to 150-gram carbohydrates for a day, but the keto diet is less than 50-gram carbohydrates. The keto diet is high in fat and, in comparison to a low-carb diet, has less protein content. The significant difference is that people on the keto diet go into a ketosis state, and they use ketones rather than carbohydrates as a source of producing energy.
Starting a keto diet and inducing ketoacidosis is harmful to people with type 1 diabetes.
Because lacking insulin for a long time is dangerous and leads to blood sugar spikes, still, the point is that people with type 1 diabetes need an external source for insulin to be injected into their bodies due to their dysfunction in producing insulin in their pancreas.
The keto diets do not allow the body to use insulin properly, and blood sugar is not controlled correctly. Uncontrolled blood sugar leads to insulin resistance, and it can raise the risk for type 2 diabetes.
A low-carb keto diet (LCKD) contributes to reducing the intake of insulin and oral antidiabetic drugs in patients with T2D. The studies have shown that the LCKD is efficient and cost-effective to manage T2D.
The diets that are considered for type 2 diabetes are usually weight-loss diets. Type 2 diabetes is associated with obesity, so the patients tend to lose weight.
It seems that a high-fat diet named the keto diet might not be proper for weight loss, but you have to note that people on the keto diet use another way of producing energy called ketosis. In type 2 diabetes patients, the keto diet has some impressive effects, such as lowering insulin dependence and improving blood sugar levels. Some review studies have shown a significant impact of the ketogenic diet compared to the control group in reducing weight, improved lipid profile, and glycemic control. The HBA1c or glycated hemoglobin and HDL had improvement in the trials of using the ketogenic diet.
You can limit your medication by following the keto diet is only type 2 diabetes, and you have to talk to your doctor to have a proper prescription.
Ketosis occurs when the body burns fat instead of glucose as a fuel to produce energy. Ketosis is the aim of the ketogenic diet.
Mild ketosis can occur in healthy younger persons and skinny people after night- fasting in those who use a complete diet but are restricted in carbohydrates is shown. We can prevent ketosis occurrence by consuming at least 100 grams of carbohydrates per day.
Ketoacidosis happens only when a considerable number of ketone bodies are produced in the body, mainly as a complication for type 1 diabetes.
It only happens if you reduce your carbohydrate intake or fast. Both conditions force the body to use up glycogen stores and then begin to break down and slow down fat for energy.
Signs of ketosis: Fatigue, Weakness, Headache, Intense cravings for sugar or carbohydrates, Bad breath (Keto breath), Digestive problems, and Insomnia.
A high density of glucose, lipid, and amino acids and their metabolites in the blood is the satiety phase index. Carbohydrate and amino acid intake can lead to insulin secretion by raising storage forms of nutrients such as glycogen, triglycerides, and protein. It can regulate their store of them in tissues. The storing function will be stopped as soon as the tissues start to break the glycogen, protein, and fat.
Fasting more than 12-24 hours can lead to a severe decrease in insulin level and the significant transport of free fatty acids and glycerol from fat tissue and amino acids from muscles. The body delivers these molecules to the liver and provides the energy and needed substances for making protein and gluconeogenesis. In the long term, the fasting liver absorbs the transported fatty acids from adipose tissues, converts their carbon to the ketone bodies, and then releases them into the blood flow.
Fasting more than 2-3 days can use all of the stored 80 grams of glycogen in the liver and almost half of the muscles' glycogen.
After 3.5 days, stop eating any food, brain glucose usage reduces up to 25% and ketone bodies' use increases in the same proportion.
Protein consumption can make the human body secrete more glucagon and insulin.
The glucagon level can remain or lower after carbohydrate consumption.
Ketosis is one of the main signs of long-term fasting. In non-fasting conditions, acetate oxidation can provide only 2-3 % of energy, and the number of ketone bodies is almost deficient.
Starvation ketosis: the presence of ketone bodies in the blood, usually on the second or third day of fasting, when the acetoacetate level increases up to 1 mmol/liter, and the beta-hydroxybutyrate increases up to 2-3 mmol/liter. The sweet smell that is characteristic of breathing is recognizable after 3 or 4 days. The ketone body's production speed reaches the maximum level on the third day of fasting, but its concentration in the blood increases in the days or weeks after that.
After 4 to 7 days of fasting, 30-40 percent of total body energy expenditure is provided by ketones oxidation.
After three weeks, the level of ketone bodies in blood flow stables.
After 3-5 weeks of fasting, brain glucose consumption decreases up to 50%.
Fat oxidation is responsible for providing 2/3 of the Rest of Energy Expenditure after the absorption phase.
An abnormal condition is one of the complications of type 1 diabetes. This condition is the reason why it is also called diabetic ketoacidosis. It can rarely occur in type 2 diabetes. Destruction of beta cells of the pancreas can lead to almost complete insulin deficiency. Therefore the fatty acids stimulate the liver to produce ketone bodies and gluconeogenesis like regular fasting.
Type 1 diabetes is a significant cause of ketoacidosis.
In 30 to 50% of cases, the infection causes diabetic ketoacidosis. These infections include urinary tract infections and pneumonia.
Another reason is that the patient does not follow the correct insulin treatment.
Although diabetes is a significant cause of ketoacidosis, other factors, such as drug abuse or severe calorie and carbohydrate intake may also contribute to ketoacidosis.
Nausea, Vomiting, Abdominal pain, Rapid breathing, shallow thirst, dehydration, Dry mouth, and Confusion.
In severe cases, a person may also have low blood pressure. Without proper treatment, diabetic ketoacidosis can lead to coma or death.
In long-term fasting of non-diabetic persons, ketone bodies' level rarely increases more than 6 to 8 mmol per liter. Still, in diabetic ketoacidosis, it can be much higher, and it can lead to a dangerous drop in pH. It is called ketoacidemia.
Ono diabetic ketoacidosis happens after ongoing vomit and decreased cellular fluid following excessive alcohol consumption and not eating food. This ketoacidemia is as dangerous as diabetic ketoacidosis, even if the blood glucose level stays in a normal range.
Depletion of body fluids and reduction in metabolism can intensify the ketoacidosis and hyperglycemia through:
♦ Reduction of the blood flow to kidneys and brain
♦ Reduction in ketone bodies oxidation in brain kidneys
♦ Severe decrease in excretion of ketone bodies in urine
Diabetic ketoacidosis may be life-threatening, but it can be treated well. The first step of treatment is to diagnose it correctly. Ketoacidosis treatment has two stages:
♦ Prescribing insulin
♦ Replacing electrolytes
Patients will be monitored until their blood ketone levels return to the normal stage.
Do you have diabetes, and are you following a ketogenic diet under specialist supervision? If so, know that you will not be at risk for ketoacidosis as long as you keep your glucose levels in a normal range.
Ketoacidosis is diagnosed when the concentration of ketones in the blood is higher than average. Abnormal levels of ketones are usually higher than 3 mmol.
The good news is that diabetic ketoacidosis can be prevented. Therefore, you can avoid ketoacidosis with constant care and attention to your health.
Here are some things you can do:
♦ Measure your ketone levels at home, especially when your blood glucose is high.
♦ Check your blood glucose levels.
♦ Tell your doctor if the dose is higher than usual.
♦ Know the symptoms of ketoacidosis. See your doctor immediately if you have these symptoms. Do the same if you feel sick.
♦ Follow the prescribed insulin instructions correctly.
♦ Stay away from infections and severe stress.
If you are away from home, be sure to use a medical diagnostic bracelet. This device will allow others to understand your situation and help you properly if something goes wrong.
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