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[Paper] Ketosis, ketoacidosis and very-low-calorie diets: putting the record straight - 2011 (infosec.pub)

submitted 2 months ago* (last edited 2 months ago) by jet@hackertalks.com to c/ketogenic@dubvee.org

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Very-low-calorie diets (VLCDs) are used to treat obesity, often in a non-clinical setting, and the typical formulation of a minimum of 50 g carbohydrates daily can induce a mild dietary ketosis. This clinically benign state is sometimes confused with the non-metabolically adapted state of ketoacidosis, and this misunderstanding may lead to the rejection of VLCDs as a suitable obesity treatment. This paper summarises and discusses the difference between physiological ketosis and pathological ketoacidosis, the benefits of ketosis-inducing weight-loss regimen such as VLCDs and why ketoacidosis should never be the diagnosis in a non-type 1 diabetic on a carbohydrate-restricted diet.

Paper https://doi.org/10.1111/j.1467-3010.2011.01916.x

Full Paper on scihub

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[–] jet@hackertalks.com 2 points 2 months ago* (last edited 2 months ago)

What about T1Ds and Ketoacidosis?

Ketoacidosis is well recognised as a pathological state. It is characterised by elevated blood glucose levels and fatty acid mobilisation, uncontrolled ketosis and raised plasma levels of glucagon, catecholamines, cortisol and growth hormone (Havel & Taborsky Jr 2003).

Three things are required - No insulin, High blood glucose, and high blood ketones.

Insulin is a super hormone, and in its absence the body doesn't self regulate. Ketoacidosis requires the absence of insulin, it cannot happen in the presence of insulin.

Does this mean ketosis is dangers for T1Ds? No, absolutely not!

Dr. Bernstein is the most outspoken T1D and keto advocate. Most famous for Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars - https://archive.org/details/drbernsteinsdia00bern - Dr. Bernstein passed away last month at 90 years old.

https://www.diabetes-book.com/laws-small-numbers/

“Big inputs make big mistakes; small inputs make small mistakes.”

My understanding from Bernstein’s work is that the reason for carb loading is to avoid hypoglycemic events, which is easier to do when carb loading (you raising the ceiling and the floor). However on a low carb intervention (after the 6 week adaptation phase) the body is using fat for most systems, so glucose dips are far less likely, and overall glycemic control becomes much better.