Ketoacidosis most commonly arises with people with diabetes. Diabetic ketoacidosis occurs in response to a severe lack of proper insulin activity whereas alcoholic ketoacidosis is a harmful metabolic condition arising when someone consumes alcohol but no food, explains Michael J. Gonzalez-Campoy, MD, PhD, medical director and CEO of the Minnesota Center for Obesity, Metabolism, and Endocrinology, in Eagan, Minnesota. Either way, this is a dangerous situation.

Ketosis Isn’t Forever.  It’s recommended that you follow this diet to arrive at a state in which your body adapts to burning fat and glucose stores for fuel. Then you’ll want to take an occasional ketosis holiday, adding a serving of unprocessed, whole grains to allow your body to chance to work less hard. Staying in ketosis long-term—without breaks— can cause muscle aches, nausea, and fatigue.
If you’re a generally healthy adult who’s looking for a new way to eat, it’s probably fine for you to try the diet. Just think carefully about your motives, intentions, and long-term plans. Any diet you follow for a short period of time might garner some initial results, but if you’re not intentional about switching to a sustainable, long-term healthy eating pattern, the benefits you see while going keto are likely to be short-lived. Be honest with yourself about whether or not you have the self-control and desire to follow such a restrictive eating pattern. If you don’t, that’s OK. The best diets are those you can legitimately sustain for a lifetime. Restriction isn’t always the best answer.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.
I have been on a low carb diet for over 2 years. I was diagnosed a diabetic with a blood glucose over 400 mg/dl and an A1C of 12. I tried my doctors recommendations for about a year and took all the medications they told me to take. not much changed. they wanted to put me on insulin after a year. I told my doctor that I thought I could control my condition with diet and he said, “you are to far gone for that”.
After your body enters this carb-deficient state, it begins burning fat to provide energy, and this burning of fat causes a release of ketones. Ketones are dense sources of energy that can stimulate critical parts of the body, such as the brain. By drastically shifting your diet from carbohydrate dependence to fat dependence, you can enjoy a number of impressive health benefits, in addition to weight loss.

While these findings are preliminary, in one study of mice, the keto diet helped reduce anxiety. The research suggests this could be due to the protective brain benefits of intake of healthy fats and low levels of sugar. A follow-up study found that mice exposed to a ketogenic diet while in utero showed less susceptibility to anxiety and depression than mice born to mothers who were not on the keto diet. Here’s what it’s really like to follow the keto diet.
For people with Type 1 Diabetes, you probably have heard of their diabetic emergency, diabetic ketoacidosis, also referred to as DKA. This can be life threatening condition for people with Type 1 diabetes and Certified Diabetes Educators spend many hours teaching preventive care for DKA. This condition should not be confused with nutritional ketosis, the fat burning state reached when following the Ketogenic diet. The two conditions are quite different.
Adding salt to food might be new to you, since most people are used to being told to limit salt intake. However, when you’re eating a ketogenic diet of less than 60 carbohydrates each day, you’ll need to make up for this loss of salt. That being said, those with high blood pressure who take medication should check with their doctors before making a change.
Adding salt to food might be new to you, since most people are used to being told to limit salt intake. However, when you’re eating a ketogenic diet of less than 60 carbohydrates each day, you’ll need to make up for this loss of salt. That being said, those with high blood pressure who take medication should check with their doctors before making a change.
Great post, Abbey!! Thank you for taking the time to write this and share it with us! This diet may work in some cases as you pointed out but i find it very dangerous, eventhouh i’m not a dietician. I tried it and i felt horrible. I felt depressed, constipated, pain in my right side which i think was my gallbladder. Couldn’t sleep, terrible breath. AWFUL!!
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.”
Other experts say the long-term accumulation of ketones could be harmful. “Those ketones are emergency fuel sources, and we’re not meant to run on them long-term,” says Kristen Kizer, a registered dietitian at Houston Methodist Hospital. “Ketones are negatively-charged molecules, which means they’re acidic. When you build up ketone bodies in your system, you’re building up acid. One of the ways your body buffers acid is by pulling calcium from your bones.” Kizer also notes that the diet isn't very balanced and involves a very high intake of animal products, which generally do not protect against cancer, diabetes, or other diseases.

Nutritionists frequently advise clients to reach for more healthy fats and protein to stay full throughout the day. With this in mind, it makes perfect sense that a ketogenic diet would be about as good as it gets for staying satiated. One study from the American Journal of Clinical Nutrition found this type of low-carb approach was more effective for weight loss and managing hunger than a similar high-protein diet with a greater percentage of carbohydrates. One 2013 study even suggested the eating plan may suppress hunger hormones more effectively than other weight-loss programs.
Early humans probably were on an LCHF diet. But when did humans become the “intelligent” species that they are? Can that be related to invention of agriculture? When humans began settling down on river banks to grow their crop, be it rice or wheat or maize, may be the rich alluvium, elevated mineral contents and higher glucose levels associated with grains might have given them increased brain activity leading to their cultural and intellectual development. My only worry is, this”new found” ketogenic diet shouldn’t push us back to stone age, though on a positive note, that might save our planet from anthropogenic destruction!
Participants returned every other week for 16 weeks for further diet counseling and medication adjustment. When a participant neared half the weight loss goal or experienced cravings, he or she was advised to increase carbohydrate intake by approximately 5 g per day each week as long as weight loss continued. Participants could choose 5 g carbohydrate portions from one of the following foods each week: salad vegetables, low-carbohydrate vegetables, hard or soft cheese, nuts, or low-carbohydrate snacks. Diabetes medication adjustment was based on twice daily glucometer readings and hypoglycemic episodes, while diuretic and other anti-hypertensive medication adjustments were based on orthostatic symptoms, blood pressure, and lower extremity edema.

The keto diet is NOT what you seem to picture. I laughed at your description as I was eating lamb chops, cauliflower rice, broccoli, followed by cheesecake. How deprived I was! You should relook at what the diet really is. By the way, my cardiologist highly recommends keto. Most people see a drastic decrease in their triglyceride/HDL ratio. Looking at total cholesterol or LDL alone is 20 years out of date! Even the AHA has caught up, and now says that it’s NOT how heart health should be judged.


Those issues can be part of what's known as the “keto flu,” Warren says. Other side effects of the keto diet, all of which are tied to carb withdrawal, can include lightheadedness, nausea, mental fog, cramps, and headaches, in addition to tiredness. Luckily, the keto flu doesn't usually last more than a week—which is coincidentally about when people start to see the number on the scale go down, says Warren.


Diets require discipline, and it is not always easy for people to follow them without indulging in a "cheat day." One day may not make a big difference in the long-term, but a recent study from the University of British Columbia in Okanagan, Canada (UBCO), found that when it comes to the keto diet, a single dose of carbohydrates may have dangerous side effects.

The ketogenic diet is a low-carb, high-fat diet, similar to a number of popular diets such as the Atkin’s diet. It is primarily known as a weight-loss diet, as it can help boost the metabolism and speed up the burning of calories. While many people think of a high-fat diet as being unhealthy, it is all about the type of fats that you consume. In a ketogenic diet, for example, your protein intake will be quite high, rather than having a carb-heavy diet. Both carbs and fats can be used by the body for energy, but when fat is the primary source of energy metabolism, the body enters a state known as ketosis.
As with any diet, precautions need to be taken. Pregnant women and those with kidney disease are not good candidates for this diet, and some people with diabetes may find that the diet increases their insulin resistance. Dairy can often spike blood sugar, so avoiding the dairy in a keto diet and taking a Vitamin D supplement might be a better option for some people. It’s important to pay attention to the way your body responds and realize that no diet is a one-size-fits-all model.

It’s the same with a keto way of eating: there is a ton of research and studies out there, and we KNOW that it works. Sure, more studies will come, and the new information will help us refine it, and we will learn how it specifically affects certain individuals in different ways…but the truth about the basics of it are all there, in the open, for all to see.
I’m following the ketogenic diet and I find it very easy, pleasant and varied. I can even say that my diet today is more varied than the previous one. I do not intend to leave this diet and I cannot really see why. My initial focus was not to lose weight, I’ve always been lean, but to feel better, well disposed. And I got it! I am very pleased, I have read a lot about it (including scientific literature) and I have influenced other people who need to lose weight or improve some aspects of their health. But from the beginning I went on my own way, without the help of a nutritionist because I did not want to suffer the influence of others’ ideas.
The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.
Several comprehensive studies and meta-analyses have demonstrated that after a few months or even a year of a low carb diet versus a moderate/high carb diet, there are no significant differences in the amount of weight lost (2,3,4,5).  I will say, however, most of these diets are NOT keto and are simply lower carb (i.e. 20%).  Also, long-term effects (beyond 1 year) are not often studied due to budgetary constraints, so interpret results as you wish.

If you want to use a ketogenic diet as a health tool, it would be wise to do so for no more than a few weeks at a time, as nobody knows how long is too long. And, of course, the period of time during which ketosis is safe can vary from individual to individual. Breaking ketosis is as easy as upping protein intake or having a glass of wine or whole piece of fruit.
The problem is: it flies in the face of the way we have been taught. Our society (as an American), and our medical community, have preached for years that FAT is bad, and you should limit it. However, recent FACTS beg to differ. So many people rail against the keto diet because they just feel that it can’t be good…after all, you eat so much fat on it, it can’t be good for you! Facts are facts…they don’t care about your feelings. Fat is not the enemy. Sugar is.
It drastically lowers the unhealthy fat located in the abdominal cavity of the body. It helps prevent type 2 diabetes and heart disease. Surprisingly, low carbohydrate diets can also increase healthy cholesterol, also called high density lipoprotein (HDL). HDL carries cholesterol molecules back to the liver, where it can be reused or excreted. Having a high amount of HDL lowers heart complications, and is usually gained by eating more fats.

The New York Times pieces also points out that studies are disproving this concern and making a case for both children and adults with type 1 diabetes to consider a ketogenic diet. Specifically, a 2018 study published in the journal, Pediatrics, which took a look at glycemic control among children and adults with type 1 diabetes who followed a very low-carbohydrate, high-protein diet. The researchers found that both the adults and children who consumed this diet along with smaller doses of insulin than typically required exhibited “exceptional” blood sugar control without high rates of complications. In addition, the study data did not show an adverse effect of a very low-carbohydrate diet on children’s growth, although more research may still be a good idea, according to researchers.
In this study, researchers compared the impact of a low-carbohydrate diet and three other diets on blood pressure and other measures of cardiovascular fitness in women. After the 12 month trial, all subjects who successfully completed their respective diet experienced notable reductions in body mass, triglycerides, and LDL cholesterol. Those in the low-carbohydrate diet group, however, had the best results.
Studies are emerging that ketogenic diets (in conjunction with other treatments) can either reverse progressive brain disorders or help repair the damage. These include traumatic brain injuries and neurodegenerative diseases like Alzheimer’s and Parkinson’s. The Wahl’s Protocol also utilizes this benefit of the ketogenic diet to help repair neurological damage from multiple sclerosis.
2. A ketogenic diet helps to increase your level of energy as well as reduce hunger. Since the ketogenic diet uses body fats as a primary source of energy, your body will have a more reliable source of energy. This will make sure that you have a lot more energy to use throughout your day. In addition, since fats are more satisfying, you will find that you fill full for longer periods of time.
I’ve practiced Keto diet and nothing is wrong with me. Yes the first few months there were side effects like headache etc… but after that your gonna get smooth. Keto diet are for those people who are badly in need to get in shape like those who have obesity because no matter what the consequences are, People who have been hanging by a thread because of obesity will do everything to make all things right again and that’s why Keto diet works for me.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Restricting carbohydrates.  Studies show that after three or four days without carbohydrate consumption, your body starts tapping its fat storage also known as ketosis. You’ll want to stay between 25–35 grams of carbs to get into ketosis, and that requires bucking mainstream, carb-heavy, and supposedly nutrient-rich foods like fruit and grains. There are good carbs you can eat that will help you stay in ketosis. Be sure to look over these more keto diet friendly fruit options.
And science is now catching up, this review paper on ketogenic diets   as a form of cancer therapy concluded: “Although the mechanism by which ketogenic diets demonstrate anticancer effects … has not been fully elucidated, preclinical results have demonstrated the safety and potential efficacy of using ketogenic diets.. improve responses in murine cancer models”

Here’s another controversial yet promising area of study: Research suggests that when patients with diabetes take on a low-carb diet (like keto), they experience improvements in insulin sensitivity by up to 75 percent, as well as a reduction in blood sugar control medications. What we aren’t sure of, however, is whether these improvements are due specifically to the effects of ketosis or to weight loss in general, so similar results could theoretically be found with any successful diet.
In a March 2018 blog post, Dr. Ede provides a range of very helpful tips for anyone already on mood-altering or psychiatric medications who want to try a ketogenic diet, such as how to talk with your psychiatrist or mental-health provider and what laboratory metabolic tests the doctor should order to help monitor your response to the diet. Most importantly, she provides details about some specific medications — notably specific antipsychotic medications, anticonvulsant medications, and lithium — that should be carefully monitored.
Diets that focus on lowering carbohydrates and increasing fat have been associated with lower levels of “bad” cholesterol and higher levels of “good” cholesterol. Furthermore, lower triglyceride levels are typically seen in those on a ketogenic diet. A better cholesterol balance and fewer triglycerides can help to protect against plaque deposition in the arteries, which can lower your risk of atherosclerosis, heart disease, heart attacks, and stroke.
And that’s the kicker -- most people “going keto,” may not actually be following a true ketogenic diet since it’s hard to know for sure if your body’s in ketosis. Mancella explains that the only formal and valid method of determining if your body is in ketosis is if there are ketone bodies being excreted in your urine. “There are strips for purchase at local drug stores that are available to determine this,” she says. “Otherwise, we’re not actually sure if we’re in ketosis, and we’re just following a ‘low carbohydrate’ diet.”
A ketogenic diet – due to its extremely low carb intake – can help address insulin resistance and in turn help with suffers of PCOS. In fact, a pilot study has concluded that a ketogenic diet led to a significant improvement in body weight, fasting insulin, testosterone markets and LH/FSH ratio in woman with PCOS. Two woman even became pregnant during the study.
The bottom line? If you’re thinking about trying the ketogenic diet, run it by your doctor first — regardless of any preexisting health conditions. And consult a registered dietitian nutritionist (find one at EatRight.org) to find a nutrition professional who can work with you to create a meal plan you can stick to. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it, as well. If you have risk factors for heart disease, you’ll want to speak with your doctor before considering the diet.
This section consists of the most common complaints and struggles that keto dieters will come across. In most cases, these risks can easily be addressed and eliminated completely. Below is a graphic for a quick look at the short terms risks of a ketogenic diet and how to remedy it. If you want to read more about the risks or solutions, scroll down for an in-depth explanation of each.
The Service offers health, fitness and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional.
The low-carb diet induces ''nutritional ketosis," Dr. Saslow tells EndocrineWeb, which is not the same as ketoacidosis. Ketones are a chemical your body produces when you burn stored fat; if you are on a low-carb diet you may be ''in ketosis.'' Ketoacidosis is different; it is a life-threatening condition in which levels of ketones and blood sugar are dangerously high, which may occur in people who have poorly controlled diabetes.
While a ketogenic diet helps normalize blood sugar (glucose) levels and can help you maintain or reach a healthy weight, an alkaline diet is beneficial for its anti-aging effects— especially lowering inflammation, boosting detoxification, and promoting hormonal balance, immunity and more. Traditional ketogenic diets usually miss the important factor of restoring alkalinity. For many patients the key is to reach an alkaline pH first before beginning keto in order to prevent feeling agitated, anxious, uncomfortable or overly hungry.
If you’re wondering about the difference between ketosis and diabetic ketoacidosis, you’re not alone. “The word ketone is scary for most people with type 1 diabetes because they relate ketones to diabetic ketoacidosis,” says Patti Urbanski, MEd, RD, CDE, a certified diabetes educator with St. Luke’s Hospital in Duluth, Minnesota. “But with the ketogenic diet, we’re talking about a much lower level of ketones.”

The study concludes, “The ketogenic diet appears to improve glycemic control. Therefore, diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels.” Previous research has also shown that for patients with type 2 diabetes, long-term administration of the keto diet lowered body weight, improved blood sugar levels and can result in a smaller needed dose of antidiabetic medication.

Based on what we know from the available research, is the keto diet safe? The evidence is clear that the KD can reliably help to treat obesity and improve insulin resistance, but the long-term impact of the KD on cardiovascular risk factors, liver disease and glucose tolerance is more controversial. Experts agree that genetics seem to play a role in how different people respond to the KD, meaning some may be more likely to thrive on very low-carb diets, while others are more susceptible to developing side effects.


Try to be patient. Although some people get into ketosis relatively quickly, it can take others a while. Unfortunately, people who are insulin resistant often have a longer journey. Put in a solid month of consistent keto eating, and try to ramp up your physical activity, if possible. Within four weeks, you should definitely be in ketosis and experiencing its benefits.
A second counterintuitive approach to healing the gut for children who are having a hard time gaining is to encourage a nice long ‘fast’ over night.  When the gut is less full, and the body can digest the food that’s in there completely and then it can repair an inflamed or leaky gut better.   If the gut is inflamed, food may be passing right through without being absorbed.  In addition, growth hormone raises during periods of fasting.
“With the start of the keto diet, the body switches from using sugar as a source of energy to using the body’s stored fat,” Rahnama explained. “In the process of breaking down fat, the body produces ketones, which are then removed by the body through frequent and increased urination. This may lead to dehydration and flu-like symptoms, such as fatigue, dizziness, irritability, nausea, and muscle soreness.”

What is the link between ketones and diabetes? Ketone is a chemical produced by the body when fats are broken down for energy. Ketone testing is important for people with diabetes, because high levels can lead to diabetic ketoacidosis (DKA), when acid levels become too high in the blood and the person loses consciousness. Find out when and why to do ketone testing. Read now
Type 1 diabetes is not caused by insulin resistance, but it still makes sense to lower the need for insulin. Because type 1 diabetics hardly produce any insulin, they rely on external insulin when following a standard high-carb diet. Through carb restriction, a ketogenic diet decreases the need for insulin. In some type 1 diabetics, their insulin production is sufficient when following a ketogenic diet. Others still need to inject insulin, but much less than on a high-carb diet. Overall, it is much easier to control blood sugar levels with injected insulin on a ketogenic diet because blood glucose raises only mildly after meals.
Congratulations to you!! Keep up the good work. And, I have to say again, choosing the keto way of life as a type one diabetic is a lot easier than one would think, right?!. It is so rewarding, as you point out, and actually quite easy (lose the carb cravings and enjoy eating everything that you can!). I honestly feel more FREEDOM eating this way than I did eating the other way for 20 years and I love the normal sugars and better energy. Also the decrease in inflammation is awesome.

Probably, and there are a few reasons why the keto diet usually equals weight-loss gold, says Keatley. For starters, people usually reduce their daily caloric intake to about 1,500 calories a day because healthy fats and lean proteins make you feel fuller sooner—and for a longer period of time. And then there’s the fact that it takes more energy to process and burn fat and protein than carbs, so you're burning slightly more calories than you did before. Over time, this can lead to weight loss.

The keto diet is an extremely effective way to lose weight over a short period of time—even better, according to some research, than low-calorie and low-fat diets. There a few reasons for this: When you’re in ketosis, your body stores less fat. Dieters feel fuller for longer, partly because of the rich food they’re eating, and partly because ketosis changes your hunger hormone levels.
The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat [12]. Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.

As Tammy points out, diets are diets, and many people nowadays think/feel that diets are a “time/value-based goal”. “If I just get my weight down, or if I just fix this, then I’ll be all set…” WRONG!!! There in lies the first problem. How long can it be maintained? Well that’s a good point. The real question is, how long is one committed to changing their life, and how strong is their desire to do it. ALL things that one wants to change in life, require a change in to the way their living and/or perceiving life. They require a life-style change. One could attempt a Mediterranean diet, and yet relapse back to “normal” eating after 3mos, 1yr, 3yrs, etc.. It doesn’t really matter if the change isn’t first on the mental and emotional level. Unfortunately, many first-world daily diets (namely American) incorporate many foods that are addictive which can cause cravings. And yes, the cravings are scientifically prove-able, and have been proved. We grow up thinking that it’s “normal” to have your cake (since its the carb of debate lol) and eat it too, because why?… Well because that’s how they were raised. Simply as that. Conditioned living if you will. There are many cultures on this planet that DO NOT grow up eating as many carbs and sweets as the American Diet, and do perfectly fine without all the sugars and carb cravings. And incidentally, they also lead healthier lives too… Go figure.


John Staughton is a traveling writer, editor, and publisher who earned his English and Integrative Biology degrees from the University of Illinois in Champaign, Urbana (USA). He is the co-founder of a literary journal, Sheriff Nottingham, and calls the most beautiful places in the world his office. On a perpetual journey towards the idea of home, he uses words to educate, inspire, uplift and evolve.

×