Demystifying Ketoacidosis Versus Ketosis

In order to understand the benefits of the ketogenic diet and the process associated with it, you should understand what it isn’t: ketoacidosis.  Ketoacidosis occurs in both non-diabetic and diabetic cases and denotes high levels of water-soluble ketone bodies which leads to acidic blood.  This relates to type 1 diabetes because this form of diabetes is essentially a result of insulin deficiency.
Normal Physiology and Insulin
Insulin is normally needed to allow your cells to absorb glucose which is used for energy and normal functioning cells.1  In these cases, your body produces ketone bodies at your liver during fatty acid metabolism so your brain, cardiac and skeletal muscle tissues can use them for fuel when your body cannot import glucose.
Diabetic Ketoacidosis
How is this different from ketosis?  Ketone bodies are always present in your blood, but under diabetic conditions, these bodies increase to pathological levels while the body still cannot use glucose.  So, how prevalent is ketoacidosis?  What are the risks?  In a study of children and adolescents in Israel with Type 1 diabetes, Eyal et. al. studied diabetic ketoacidosis (DKA) to identify risk factors.  Interestingly enough, it was found that age, maternal origin, and paternal education levels were all factors in the development of diabetic ketoacidosis.2
More in depth, the Type 1 diabetics in the study had higher levels of ketoacidosis (35.6% in Israel) than those in other developed countries, which the researchers thought was due to a low level of awareness of DKA (0.024% in the US).  Younger patients were also more affected which the authors attributed to higher levels of dehydration, a fast decline of Beta cells in the liver that produce insulin, and the reduced ability of younger individuals to compensate metabolically for the acidosis.
Non-Diabetic Ketoacidosis
In some cases, pediatric patients can suffer from non-diabetic ketoacidosis.  In a study by Bai et al, 5 patients with non-diabetic ketoacidosis were studied.3  They were dehydrated, had poor appetite, and had Kussmaul breathing.  Kussmaul breathing is a fancy medical term meaning deep labored breathing that has to do with acidosis.  When the blood becomes acidic, it causes a shift in your body’s system that regulates your blood pH.  Long story short, the acidity initiates a chemical reaction that converts acidic compounds to carbon dioxide.  What does your body do with carbon dioxide?  It pushes it out through your lungs.  As your body is trying to compensate for this high acidity in your blood, it makes you breathe harder to get out the carbon dioxide.
Clearing Up Confusion
In ketosis, a normal, healthy biological process, your body produces manageable levels of ketones.  In ketoacidosis, patients are treated via insulin and glucose administration to correct ketoacidosis in order to have normal functioning physiology.  These two states couldn’t be any more different: ketosis and ketoacidosis.  One wreaks havoc on your body and the other allows you better health and controlled weight loss.  They’re not to be confused.