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Re: [IP] ketosis

Miranda Miller wrote:
> I just read a fiction book where a girl who's been diabetic for years
> decides that she's too fat, so takes less insulin so she'll have ketones
> and lose weight.  Now I was diagnosed as a 20-year-old in long-onset Type
> I so I don't have experience with ketones and I'd like to understand this. (snip)
> I've had ketones a couple times when I've gone running
> strenuously-- I guess burning fat.  Does anyone really understand
> ketoacidosis? It's something I've never experienced and hope I never will,
> but I'd like to understand it.

First off, there is a difference between ketosis and ketoacidosis.
Ketosis is the result of the body breaking down fat and protein, and can
occur in a number of different situations, and in non-diabetics.

For example, in starvation, when the body isn't getting enough glucose,
it will break down fat and muscle for energy, resulting in the extreme
wasting that you see in the skinny babies with bloated bellies.

People who are attempting to lose weight rapidly by eliminating carbs
(remember the old all-protein diets?) can also show ketosis. 

It occurs in alcoholism when a person is drinking rather than eating and
not consuming enough calories.

It can occur after heavy and prolonged exercise, when the body has
exhausted its stores of glycogen and needs an energy source. That's why
marathon runners consume carbs periodically while running. 

In other words, ketosis is a normal response to lack of glucose, even
when the ability to produce insulin is unimpaired.  

In the normal person, the amount of ketones produced can be used by the
body, and while some amount may spill in the urine, it's NOT a crisis,
and doesn't signal risk of death if the condition causing it is promptly
taken care of. Carbohydrates will stop the production of ketones.  

Ketoacidosis is another animal -- it's essentially an extreme form of
ketosis where the body's acid-base balance is overwhelmed by the huge
production of ketones, and the body is unable to use them or excrete
them fast enough to avoid acidosis. It's caused by the near total lack
of insulin -- again, the body cannot use glucose, so it resorts to
breaking down fat and protein.  

As you know, this is a classic sign of Type 1 diabetes. And IS an
indication that death is near. 

Some Type 1's have ketosis, but not ketoacidosis when diagnosed. Type
2's in crisis will also frequently have ketosis, but not ketoacidosis.
It's basically a difference of degree. 

And I also hope none of us, now that we've been diagnosed, ever go into
ketoacidosis -- it's definitely a dangerous state of affairs!

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