Nutritional ketosis vs. ketoacidosis

Nutritional ketosis and diabetic ketoacidosis are completely different situations. While nutritional ketosis is safe and health-beneficial, ketoacidosis is a medical emergency.

Unfortunately, many medical professionals don’t really understand the difference between the two.

Ketoacidosis occurs mainly in people with type 1 diabetes if they are not getting enough insulin to meet their needs. In diabetic ketoacidosis (DKA), blood sugar and ketones rise to dangerous levels, disrupting the delicate acid-base balance in the blood.

In trophic ketosis, BHB levels are usually maintained below 5 mmol/L. However, patients with diabetic ketoacidosis tend to have BHB levels above 10 mmol/L, which is directly related to their inability to produce insulin.

This graph shows a huge difference in the amount of ketones in the blood between ketosis and ketoacidosis:

Other people who may develop ketoacidosis are those with type 2 diabetes who take SGLT-2 inhibitors, such as empagliflozin, canagliflozin, dapagliflozin and ertugliflozin.

In addition, in rare cases, women without diabetes can also develop ketoacidosis while breastfeeding.

However, ketoacidosis is almost impossible for most people who are able to produce insulin.

Signs that you are in ketosis

There are several signs that you have ketosis, although measuring your ketone is the only objective way to verify it. The following are the most common signs and symptoms:

• Dry mouth or metallic.Increased thirst and more frequent urination.
• “Ketogenic breath” or “fruit breath”, which may be more pronounced to others than yourself. Learn moreInitial fatigue, followed by an increase in energy.
• Decreased appetite and food intake (which is a more popular side effect!)

Measuring ketones

There are three ways to measure ketones, and they all have pros and cons. For a detailed comparison, see our complete guide on the best ways to test ketones.

1. Urine strips are the simplest and cheapest way to measure ketosis. It is the first option for most beginners on a keto diet.
2. Breath ketone analyzers These analyzers vary in their specific results. Some older models do not give you a precise ketone level; rather, they provide a color code for the general level. Whereas other, newer models, report a specific number or level.
3. Blood ketone meter Blood-ketone meters show the exact and current level of ketones in your blood.