Ketosis- Carbohydrate Deficiency

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By Medifit Education



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Ketosis is a metabolic process that occurs when the body does not have enough glucose for energy. Stored fats are broken down for energy, resulting in a build-up of acids called ketones within the body.

Some people encourage ketosis by following a diet called the ketogenic or low-carb diet. The aim of the diet is to try and burn off unwanted fat by forcing the body to rely on burning fat for energy, rather than carbohydrates.

Ketosis is also commonly observed in patients with diabetes, as the process can occur if the body does not have enough insulin or is not using insulin correctly. Problems associated with extreme levels of ketosis are more likely to develop in patients with type 1 diabetes compared with type 2 diabetes patients.


Ketoacidotic syndromes are frequently encountered in acute care medicine. This article focuses on ketosis and ketoacidotic syndromes associated with intoxications, alcohol abuse, starvation, and certain dietary supplements as well as inborn errors of metabolism. Although all of these various processes are characterized by the accumulation of ketone bodies and metabolic acidosis, there are differences in the mechanisms, clinical presentations, and principles of therapy for these heterogeneous disorders. Pathophysiologic mechanisms that account for these disorders are presented, as well as guidance regarding identification and management.

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People still die from diabetic ketoacidosis. Poor patient education is probably the most important determinant of the incidence of the catastrophe that constitutes “DKA”. In several series, only about a fifth of patients with DKA are first-time presenters with recently acquired Type I diabetes mellitus. The remainder are recognised diabetics who are either noncompliant with insulin therapy, or have serious underlying illess that precipitates DKA.

Most such patients have type I (“insulin dependent”, “juvenile onset”) diabetes mellitus, but it has recently been increasingly recognised that patients with type II diabetes mellitus may present with ketoacidosis, and that some such patients present with “typical hyperosmolar nonketotic coma”, but on closer inspection have varying degrees of ketoacidosis.


Many dieters develop ketosis symptoms that let them know ketones are present. For many people beginning a low-carb diet, ketosis kicks in after a few days with minimal carbohydrate intake. In fact, most low-carbohydrate plans have an initial phase in which dieters take in extremely low amounts of carbohydrates (usually less than 25 grams per day) in order to kick start ketosis.

You can test for the presence of ketones in the urine using ketosis strips. Many symptoms may also indicate that your body is in ketosis.

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Ketosis afflicts lactating dairy cattle of all ages, increasing during peak production years. It may occur two to three weeks prepartum to four months Postpartum.Common symptoms are diminished appetite, decreased milk, nervousness, profuse salivation, unnatural gait, licking themselves, grasping hard objects and damaging mouth, becoming explosively excited and unmanageable. clinically, animals reveal lack of alertness, eyes lack luster, rumen is hard and partially empty and noisy, feces are abnormally firm, and urine is clear, showing characteristics color responses to the Ross modification of the Rothera test. Stress factors may cause ketosis such as high production indigestion, milk fever, partial starvation, metritis, mastitis, and ovarian cysts


Ketosis does not usually occur in healthy individuals that eat balanced diets and regular meals. Drastically reducing the amount of calories and carbohydrates that are consumed, exercising for long periods of time and being pregnant can all trigger ketosis.

In patients with diabetes, ketosis and eventually ketoacidosis may occur if insufficient insulin is used to properly manage the condition, if meals are skipped, or if an insulin reaction occurs (often while asleep). Diabetic ketoacidosis is considered to be an emergency as it can lead to diabetic coma and even death. Treatment is usually administered by emergency health care workers, followed by hospitalization.

For diabetic patients, the following measures are commonly taken:

  • Fluid replacement – to rehydrate the body and dilute the excess sugar in the blood
  • Electrolyte replacement – these are needed to help keep the heart, muscles and nerve cells functioning correctly. Levels in the blood often drop in the absence of insulin
  • Insulin therapy – to reverse the processes that caused the episode of ketoacidosis.

Among otherwise healthy people, ketosis can be prevented by following a healthy, balanced diet and exercising regularly. In addition, there are a number of measures that people with diabetes can take to help prevent ketoacidosis:

  • Monitor blood sugar levels carefully and frequently – at least three to four times a day
  • Discuss insulin dosage with a specialist and follow a diabetes treatment plan
  • Keep an eye on ketone levels with a test kit, particularly when ill or under stress.

Microsoft PowerPoint - Ketone figures

By Medifit Education