Ketones, Low Carb Diets and Diabetes

12/08/08 Disease Basics

Somewhere in the recess of my mind I knew that ketones were significant in diabetes care, but I couldn't recall why. Then I stumbled across information about how people who follow low carbohydrate diets are more likely to have unhealthy levels of ketones in their bodies. I only consume 100 grams of carbs daily. I realized I needed to re-educate myself about ketones, why they are a problem, and whether I am at an increased risk.

A Definition
Ketones are produced when the body burns stored fat for energy. Typically, carbohydrates are broken down into glucose, which travels in blood to cells. Insulin helps the body use sugar (glucose) for energy. Glucose is vital for cell function. Glucose is also released by the liver if you haven't eaten for a while or during the night when you are asleep. However, the stored glucose in the liver is depleted quickly. When this occurs, the body is starving. At this point the body will start to break down stored fat for energy, and produce ketones.

The Problem
The concern presents itself rather obviously for us with diabetes. If we don't have enough insulin our glucose rises. If it elevates too high, then it is passed through our urine. In the process, the body uses all available fluid in order to dilute and help pass the glucose. This leads to dehydration. If the body can’t process enough glucose it begins to burn fat. The body is starving, dehydrated, and now producing ketones. This waste product then makes your chemical balance too acidic and the body can develop a life-threatening condition: ketoacidosis.

Risk
I read this information and was obviously concerned. My sugar levels are sometimes above 250 mg/dl, which is a marker the American Diabetes Association indicates as an increased chance for ketone production. I also drink a fair amount of caffeine and workout quite often, both of which can aid in dehydration. Then of course I had my diet to consider. Fortunately a low carb or “ketosis” diet (now I understand the name) is defined as carbohydrate intake that is less than 20 percent of the total caloric intake, and closer to 5-10 percent. I don’t fall under that category.

What Now
After my search I decided to buy a vial of keto-sticks, which are strips for measuring the presence of ketones in urine. Now, whenever my blood sugar is elevated above 250, or if I have not rehydrated after exercise, or if I know I have not eaten carbohydrates in some time, I use one. It means one more test, but it's in the name of good health.

Eric Devine, 30, has lived with type 1 diabetes since he was 12. He lives in upstate New York with his wife and two daughters where he works as a high school English teacher. Devine is an avid writer and is currently seeking publication of two Young Adult novel manuscripts.