What is diabetic ketoacidosis? When a diabetic (usually a Type I diabetic, but sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fails to receive enough insulin, they go into an effective state of starvation.  While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells.  Hence, they are effectively going into starvation.  The body does what it would do in anyone – it starts to make ketones out of fat and proteins.  Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones without stopping.  By the time ketone levels (specifically, beta-hydroxybutyrate) approach 15 to 25 mM, the resulting pH imbalance leads to profound metabolic derangement and the patient is critically ill.


Chronic exercise patterns: Fat-based metabolisms are great for long, slow movement, quick bursts of speed with rest in between, and feats of explosive strength. In other words, making your way through the world, doing some strength training, going for hikes, playing with kids, running some sprints, and are all tenable on keto. Heavy CrossFit training or anything else that burns a lot of glycogen at a lot of workouts each week, however, might pose issues. Resolve this by either scaling back the training or eating some carbs before, during, or after your workouts.

Another possible nutrient deficiency: potassium, a mineral important for both electrolyte balance and blood pressure control, notes MedlinePlus. “Inadequate intake of potassium is likely when consumption of fruits and starchy vegetables are decreased,” says Asche. She recommends adding lower-carb sources of potassium to the diet, including avocado and spinach — as well as lower-carb sources of fiber, such as chia seeds and flaxseed (be sure to enjoy ground for the best health benefits).


A ketogenic diet elevates the levels of ketone bodies in the system—these are the byproducts of the body breaking down fat for energy when carbohydrates are in short supply, a process called ketosis. The average American gets most of their energy from glucose, which comes from carbs and sugars. When you’re in ketosis, though, your body goes into hyper fat-burning mode, also using up stored body fat, which is why it’s effective as a weight-loss strategy.  


There’s many suggested interventions for these short-term keto side effects on the internet, but know that there are potential pitfalls of these dietary supplements. While there are benefits for some specific cases, many of us will experience nausea, vomiting, diarrhea, and constipation as a result. Plus, unless they’re prescribed to you by a physician, dietary supplements come with their own safety gamble.
A ketogenic diet puts the body in a state of ketosis, where the primary fuel for the body is a broken down product of fat called ketone bodies. Ketosis can occur through reduction of carbohydrates in the diet or through fasting (or through taking an external ketone-producing product). It is the liver that produces ketone bodies by breaking down fatty acids, either from body fat or the fat that we eat.

The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).

By going on a ketogenic diet, you are far more likely to increase your level of fiber intake, primarily through fruits and non-starchy vegetables. This increase in dietary fiber will help aid digestive health by promoting peristaltic motion and easing the passage of bowel movements. This can lower your risk of indigestion, constipation, diarrhea, bloating, cramping, gastric ulcers and even colorectal cancer.
Regarding metabolism: one study found when men on either the ketogenic diet or the low-fat diet were compared, their resting metabolic rates were not different despite lowered T3 on the ketogenic diet.21 Of the several studies done on the ketogenic diet, none have reported significant cases of hypothyroidism–essentially, the thyroid can function fine while following a ketogenic diet.
The low-carb, high-fat approach to the keto diet limits the types of foods you can have, and entire food groups are eliminated entirely. Beans, legumes, and whole grains are out, as are many fruits and vegetables. Many of these foods carry vitamins, minerals, and other nutrients you can’t get from any other source, and without them, you may start to experience nutritional deficiencies.
Insulin resistance is caused by several mechanisms, one of which is chronically elevated insulin levels. So what increases insulin levels? Mainly sugar. A poor nights sleep can do it too, but sugar is a big one. This can be sugar that is part of our diet or carbohydrates that are broken down to glucose or other simple carbs. Proteins put together with fats can also be converted into sugar, a process called gluconeogenesis. However, it is really the effect of dietary refined sugars and starches (flour) causing blood sugar and insulin spikes (not protein). These insulin spikes from added sugars and flour are then often followed by a blood sugar crash, leading to a sense of discomfort, even sweating, and usually a craving for more high-carb foods.
Registered dietitian Julie Stefanski is based in York and has specialized in the ketogenic diet for more than a decade. She also advocates for anyone starting keto, especially individuals who have not seen a doctor in more than a year, to first see a physician and/or registered dietitian to have their lab work checked and monitored. She also notes there are certain medications that cannot be used while on a ketogenic diet.  
Most anyone who has struggled with keto side effects or just hasn’t felt good on a ketogenic diet stands to benefit greatly from exogenous ketones during the adaption phase and beyond.  Additionally, for people who have poor liver or gallbladder function, have poor mitochondrial health, or have never tried a ketogenic diet; the process of producing ketones can be stressful.
A ketone body (KB) is a byproduct formed during the conversion of fatty acids to fuel. Some fatty acids are oxidized by the liver for energy production. Others can be partially oxidized to form the substrate acetoacetate, which is then converted to beta-hydroxybutyric acid; collectively, these are termed ketone bodies. Ketones can be used by all tissue containing mitochondria, which includes muscle and the brain.
Given all the buzz, adopting a ketogenic diet may be the perfect weight loss plan, especially if you have diabetes, or want to try this approach to lose those troublesome extra pounds. After all, it’s a very low-carb meal plan that promises effective weight loss while also lowering your blood sugar to the point where you could possibly stop taking medication. By all accounts, the “keto” diet, as it’s widely known, may even reverse type 2 diabetes, at least for some lucky individuals.
Diet Doctor has a number of videos and posts about positive impacts of the ketogenic diet for migraines, brain cancer, and traumatic brain injury. Recently, two psychiatrists reviewed the research base for psychiatric issues and noted that while promising, it is slim. Dr. Ede takes a more hopeful view. “My mantra is that the most powerful way to change your brain chemistry is by food, because that’s where brain chemicals come from in the first place,” she says.
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