Question about ketoacidosis (low Diets in HC and others)

First leave the clear terms, lest it be wrong ...

What is ketoacidosis?When the body begins to produce ketones or when the body has so many ketones that it begins to be toxic?I think it's the second but not so someone corrects me please.

Assuming that it is the second ... producing ketones is not serious for a diabetic right?I mean, a healthy person also produces ketones by ketogenic diet (burning fat to produce energy) and nothing happens, why do we do?Why does not reach toxic levels?A healthy person can never have ketoacidosis?Because!?

On the other hand, in our case, it is assumed that if we do not have basal insulin, your body begins to generate ketones since it cannot produce energy from hydrates without insulin.I understand that but ... why is it a problem for us?I mean ... we can't produce ketogenesis without reaching ketoacidosis?

I have no idea, but I think that in a healthy person there is some regulatory mechanism to avoid reaching toxicity (ketoacidosis) and we do not, hence the risk for us.But is that risk so rigorous?I mean ... if we are 12 hours without basal insulin, is it a risk?Is it a bad idea?

As you can see, I have clear things in general terms, but at the time of specific things ... hehe.I would like to understand more :)

Thanks in advance who can give a little light on the subject

Ketoacidosis is very serious, acidifies blood and can be deadly.
In diabetics without insulin, a ketosis can end in ketoacidosis and coma.
Everything depends on having enough insulin or not.

But how much sensitivity are we talking?It is not the same to say that ketosis can end in ketoacidosis at 12 noon, that after 20 days, right?

In fact, I think that many people find out that they are diabetic because they enter ketosis, lose weight, etc.That is, it seems that they are in this state a long time before realizing the problem.So it does not seem that ketoacidosis is something easy to achieve

Is it possible to carry a ketogenic diet being diabetic?For example, if you only use basal insulin and sufficient carbohydrates so as not to fall into hypoglycemia slowly, and do you dispense with rapid insulin and hydrates rations ... is it sustainable/feasible?Would the body produce energy based on fats (ketosis) without becoming ketoacidosis thanks to basal insulin?

If you have the glucose controlled, you are not going into ketoacidosis.If you do not have enough insulin and you stop getting basal, it is a matter of two days that you enter into a coma.
Before the type1 lived with slow insulin alone, but we already know how they ended in a short time.

Basically the difference between a diabetic ketosis/ketoacidosis and a fasting ketosis is the absolute lack of insulin in the first, and not in the second.

A non -diabetic is able to start ketosis but there will always be a minimum of blood glucose that enters the tissues that need it thanks to the fact that there will always be insulin (little) that will allow their entry into them.Simply, what happens is that the main source of energy of the body becomes the ketone bodies from fat and amino acids from protein catabolism (diet proteins and their own).But there is always a glucose flow to insulin mediating cells.

In a diabetic ketosis/ketoacidosis, the problem is not that there is a lack of contribution of carbohydrates, but that there is no glucose entry to some tissues that need insulin for it, with which the generation of ketone bodies is triggered and withoutControl, which ends up unbalancing acid-base balance and causing metabolic acidosis (ketoacidosis).

It is possible for a diabetic to make a ketosis diet if it is able to adjust the insulin contribution to resemble the one that would have a non -diabetic making a ketogenic diet, so as not to cause hypoglycemia or insulinopenia.Another thing is that this is recommended or not.

Basal insulin would be equated with that little insulin that would have a non -diabetic?

Technically, if you just get the basal, you can't enter ketoacidosis right?And if you do not put the fast and keep a diet of 5-10% HC, 20% protein and 70-75% fats, would you technically be obtaining energy from ketosis?I suppose that for a diabetic maintaining this control is more risky and perhaps it is not recommended.I do not say that I will practice it, but I would like to understand the theory and how it affects.

Exactly, basal insulin would be the one that would be equated with that of non -diabetic.

Theoretically, you would not enter ketoacidosis, but you could have a tendency to hypo until it was adjusted (surely the basal interprandial secretion of a non -diabetic that makes ketosis diet is less than one that does).Or maybe hyper, if you make a very hyperproteic and fatty meal and then by gluconeogenesis you generate a lot of glucose from the protein and glycerol of triglycerides (which would be the great component of dietary fat)

Regarding what you propose, a priori is more risky for a diabetic, but there is a forum user, @yessica_a who comments that he does not have hypos and has a very stable profile, with low carbohydrate diet.She comments that it is not a diet for everyone, but that she is doing well.It is in this post:

Am I doing things well with the control of my glucose? Link

Greetings!

In my case, I don't think it is a ketosis always maintained because there are days that I put more hydrate than others and would leave ketosis.And theoretically enters ketosis maintaining hydrates below 50gr per day but there are people who need to lower more.
Anyway, I was progressively going down the hydrates and I have experienced with fasting (due to illness and for not being hungry) and I have more tendency to mild hyperglycemia (150-160) at certain times of the day than to hip.But this does not have to be the same for everyone and it will depend a lot on how tight the basal is and if the needs are more or less stable throughout the day or pump is used and can be adjusted either by sections.I did not have to touch it when it came down, just the fast.And some days of the month for hormones I have to upload it to avoid hyper at night.
But each body is different.
I am in a Facebook group of type 1 diabetics with low hydrates diet (some are parents of children with diabetes) and none has commented on no ketoacidosis problem or hypos between hours, but each one takes it a little in their own way and it putsThe hydrates you see that they are doing well.Some eat more and others less.What we all try is to remove everything we give us and the improvement in the graphics is incredible in a matter of days, just lowering the hydrate.
There are also American groups that strictly follow dr Bersteinin and that only 30gr daily (I say it by heart and the amount was not fixed but I think it is 30) and half in children and they are doing well.They have non -diabetic graphs.Dr Bersntein himself is diabetic since the age of 12 and now has 83 and very good health and carries with that diet from 40 and something.
So there are many cases in which low hydrates diets work very well and get very good glucose.I do not know if they can have long -term problems because there are missing studies, there are very few and short -lived with diabetics but because of the experience of people who have done so for years it does not seem to cause problems although it cannot be affirmed safely until there are no studiesserious about it with follow -up for several years.
Dr Bernstein's book for those who do not know it is called Diabetes Solution and is a very complete manual of everything related to diabetes, based on their experience and knowledge as a doctor.Explain effects of different insulins, such as clicking and better sites, which have to look at analytics, because certain vitamins, possible complications of the disease, etc. are important.It is very complete and you learn a lot.The bad thing that is only in English although there is a translated chapter online.It also has videos on YouTube where you answer doubts that send you, you usually upload one a month.

Another detail:

farce said:
in fact I think that many people find out what they are diabetic because they enter ketosis, lose weight, etc.That is, it seems that they are in this state a long time before realizing the problem.So it does not seem that ketoacidosis is something easy to achieve

Eye, here more factors come into play:

In the debut, the person has lost a lot of beta cell mass, but not all.That is, it still has the capacity to release insulin.But hyperglycemia maintained for days and days causes what is called glucotoxicity , that is, it leaves beta cells stun and stop working (but they are alive).This process is fast, but not fulminating, hence they can be halfway between ketosis and ketoacidosis, which is still a continuum: you do not pass from having a pH of 7.4 to one of 7.1 and a bicarbonate of24 to one of 6 in an instant, but it is something progressive.

Once the patient is treated with insulin and the metabolic situation is normalized, little by little that dough of bold cell stunned again, and that is when the famous honeymoon is entered .

But a patient with type 1 diabetes of many years of evolution, the usual thing is that he has no pancreatic reserve.And therefore if insulin is stopped, in this case it is true that becoming well to be in ketoacidosis is a matter of a couple of days, as @"regina" has told you.

With low hydrates diet it is important to control hyperglycemia and correct when before to avoid problems.And in cases of illness or some drug that rises the glucose then rise basal and quickly correct as many times as necessary because it is easier to enter ketoacidosis.

Yesssica_a said:
In my case I don't think it is a ketosis always maintained because there are days that I put more hydrate than others and would come out of ketosis.And theoretically enters ketosis maintaining hydrates below 50gr per day but there are people who need to lower more.
Anyway, I was progressively going down the hydrates and I have experienced with fasting (due to illness and for not being hungry) and I have more tendency to mild hyperglycemia (150-160) at certain times of the day than to hip.But this does not have to be the same for everyone and it will depend a lot on how tight the basal is and if the needs are more or less stable throughout the day or pump is used and can be adjusted either by sections.I did not have to touch it when it came down, just the fast.And some days of the month for hormones I have to upload it to avoid hyper at night.
But each body is different.
I am in a Facebook group of type 1 diabetics with low hydrates diet (some are parents of children with diabetes) and none has commented on no ketoacidosis problem or hypos between hours, but each one takes it a little in their own way and it putsThe hydrates you see that they are doing well.Some eat more and others less.What we all try is to remove everything we give us and the improvement in the graphics is incredible in a matter of days, just lowering the hydrate.
There are also American groups that strictly follow dr Bersteinin and that only 30gr daily (I say it by heart and the amount was not fixed but I think it is 30) and half in children and they are doing well.They have non -diabetic graphs.Dr Bersntein himself is diabetic since the age of 12 and now has 83 and very good health and carries with that diet from 40 and something.
So there are many cases in which low hydrates diets work very well and get very good glucose.I do not know if they can have long -term problems because there are missing studies, there are very few and short -lived with diabetics but because of the experience of people who have done so for years it does not seem to cause problems although it cannot be affirmed safely until there are no studiesserious about it with follow -up for several years.
Dr Bernstein's book for those who do not know it is called Diabetes Solution and is a very complete manual of everything related to diabetes, based on their experience and knowledge as a doctor.Explain effects of different insulins, such as clicking and better sites, which have to look at analytics, because certain vitamins, possible complications of the disease, etc. are important.It is very complete and you learn a lot.The bad thing that is only in English although there is a translated chapter online.It also has videos on YouTube where you answer doubts that send you, you usually upload one a month.

Could you help me a little?I am debuting and I have some doubts that maybe you could answer me.The sides to prick, the rapid better in abdomen (I samp around the abdominals, on the sides of the typical Lorzilla, I do not know if I do it well) and the slow one in the legs, right?Regarding the analytics, what does it say that you have to take more into account?And the vitamins, what are the to take into account?Greetings and thanks!

Dr Bernstein is recommended to put it on the top of the buttock that is more fat to avoid clicking on muscle that can cause a fat drop.The rapid in any of the usual puncture areas (search online that there are images where the sites are indicated and when you go to the endocrine also ask).It is important to vary the area to give time to recover from the puncture.
About analytical the book tells you how typical the endocrine usually ask for you but explains that it is everything and because it is important.It is an entire chapter so I can't get all here.But don't worry because you already know what I will ask.
As for vitamins, vitamin D is very important that diabetics usually have deficiencies and sometimes it is necessary to supplement or be more in the sun.It's at least they have never asked me at analytics.The body itself synthesizes when you put yourself in the sun but as there is so much fear of the sun and people use creams there is always a lot of population with deficiencies.With 10 minutes of sunny a day without cream it should be enough but there is no longer an analysis to see if the levels are fine.
Group B vitamins, C and E. are also important. Those are obtained through food.If you are a vegetarian, the B12 need to supplement it, ask your endocrine in that case.