September 27, 2013

The Fine Line Between Ketosis and Acidosis in Diabetes


fine-lineIn diabetes, we balk at the word ketosis. If ketosis is accompanied with elevated blood sugar and acidosis coexists, this can be a life threatening condition known as diabetic ketoacidosis or DKA. Can ketosis be safely achieved in a person with diabetes? Diabetes Metabolism Research and Reviews published the study answering this question.

Ketosis, is the burning of fat for energy without an imbalance in glucose. People with T2D of sub-Saharan African origin and African Americans have shown that despite their T2D, they have achieved ketosis without acidosis. This condition is characterized as diabetic ketosis without acidosis (DKWA). Researchers question if DKWA should be included as a subtype of ketosis-prone T2D. Is this safe?

The study included evaluation of 594 Chinese in patients with newly diagnosed T2D. The patients were divided into ketosis-resistant diabetes (KRD), DKWA and DKA groups based on urinary ketones, blood pH, and bicarbonate levels. The blood glucose and c-peptide levels of the patients were also evaluated.

The prevalence of KRD, DKWA, and DKA were 78.33%, 19.72% and 1.95%, respectively, in the study population. The clinical characteristics of patients with DKWA group patients were similar to those with DKA, except that DKA patients had higher blood glucose and deteriorated β cell function.

DKWA and DKA patients share similar clinical characteristics, DKWA should be considered ketosis-prone type 2 diabetes. Therefore, the prevalence of ketosis-prone type 2 diabetes might be underestimated. This article is protected by copyright. All rights reserved.

Usually my 2 cents are withheld but this time, I have an observation. Insofar as T2D people with ketoacidosis and T2D people who have ketones but do not have acidosis going on, it’s not clinically similar. Yes, ketones are present in both people but ketones in the presence of elevated glucose results in a toxic byproduct.

Burning fat for fuel, with good blood sugar, is perfectly healthy. This is what the body was meant to do. The evolutionary advantage of burning fat for fuel is that it provides and very healthy source of energy for the body. Bodybuilders do it all the time. Are they unhealthy?

Visit Your Diabetes Health for more resources about health.