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Is Ketosis Safe? Ketoacidosis vs Ketosis: Low Carb Science: Thomas DeLauer

Ketosis is a state in which the body starts burning fat for energy due to lack of new glucose in the diet.

Carbohydrates provide the body with glucose. The pancreas secretes a hormone called insulin that works with the glucose in the bloodstream to provide energy to the body’s organs and cells.

When the glucose supply is exhausted, it begins to break down stored fat to meet its energy needs for normal functioning. The accumulation of ketone molecules in the blood makes it extremely acidic. This irritates the kidneys, which flush out ketones through urine.

Ketosis gets its name from the ketones that are produced in the process of breaking down the fat. In a healthy person, the amount of fat that is burned and ketones that are produced is tightly controlled, causing no harmful side effects.

Ketosis, or nutritional/dietary ketosis, is commonly seen in those participating in low-carb diets (as well as prolonged periods of fasting or starvation) and can be quite helpful in losing weight, as fat is burned in the entire process to gain energy

As ketosis is usually a diet-induced process, it isn’t harmful

However, ketoacidosis, which is seen in people suffering from a lack of insulin, is a life-threatening condition. (1)


Ketoacidosis, also known as diabetic ketoacidosis (DKA), is a life-threatening condition in which your body doesn’t make enough insulin. This can cause you to have dangerously high levels of ketones and blood sugar.

Think of DKA as a dangerous state of ketosis

It is a condition afflicting mainly type 1 diabetes patients who suffer from hyperglycemia as a result of lack of insulin.

Inadequate insulin levels result in the failure of the body to utilize blood glucose as a fuel source; rather, to compensate the decreased energy levels, the body starts breaking down fat, resulting in ketones.

Without insulin to control the amount of ketones produced during this process, an excessive amount is produced
When excessive amount ketones build up in the blood, it seriously alters the normal chemistry of the blood and interferes with the functions of multiple organs.

They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death.

Ketoacidosis is always accompanied by dehydration, which is caused by high levels of glucose in the blood. Glucose builds up in the blood if there is not enough insulin to move glucose into your cells (1,2)

The Difference

Diabetic Ketoacidosis (DKA) is a very dangerous state where an individual with uncontrolled diabetes is effectively starving due to lack of insulin. Insulin brings glucose into our cells and without it the body switches to ketones.

Our brain can function off either glucose or fat and ketones. Ketones are a breakdown of fat and amino acids that can travel through the blood to various tissues to be utilized for fuel.

You see, in normal individuals, or those with well-controlled diabetes, insulin acts to cancel the feedback loop and slow and stop the overproduction of ketones. Without this feedback loop, dangerous levels of ketones build up, acidifying the body.

This would register on a Ketone Meter at levels of 20 mmol/l. The levels can build up to a state that is highly toxic.

If someone is in this state, they are usually accompanied with excessive thirst and urination, hyperglycemia, pain, nausea, and deep, labored, gasping breathing. These individuals need to seek medical treatment (2)

Who is at risk?

DKA can occur very quickly and symptoms of DKA can develop over a period of a few hours, and treatment results in rapid recovery

People with type 1 diabetes are at risk of diabetic ketoacidosis. If you have type 1 diabetes, ketoacidosis can occur because you have stopped taking your insulin injections or because your insulin dose is too low.

It can be triggered by an infection or severe physical stress, such as an injury or surgery, because your body can need more insulin than usual during these stresses. Ketoacidosis rarely occurs in people with type 2 diabetes.

In most people who have type 2 diabetes, blood insulin levels usually do not get low enough to signal the liver to make ketones. (3)


1) Understanding Ketosis vs Ketoacidosis. (n.d.). Retrieved from

2) Why DKA & Nutritional Ketosis Are Not The Same. (n.d.). Retrieved from

3) Diabetic Ketoacidosis Guide: Causes, Symptoms and Treatment Options. (n.d.). Retrieved from