What’s the Difference Between Ketosis and Diabetic Ketoacidosis

Many strive for ketosis for health advantages, which include decreased body weight and increased energy. Yet, excessive ketone production in patients with type-1 diabetes is a health concern known as diabetic ketoacidosis. Here, we'll review the diagnostic criteria, symptoms, and treatment options for ketosis and diabetic ketoacidosis.

Due to its many reported health advantages, the ketogenic diet has recently gained popularity. Losing weight and feeling more energized are two major benefits. People often force themselves into a ketosis state to get health advantages. For this reason, they stay free of any metabolic issues. Ketoacidosis is a potentially fatal reaction to some diabetic medications. The two states, ketosis and ketoacidosis, are distinct from one another.

Ketosis Vs. Ketoacidosis

Characteristics Ketosis Ketoacidosis
No. Of Ketones Low High
Causes Diet Diabetes I
Health Benefits Weight Loss None
Effects Weakness Vomiting. Nausea, Weakness
Dangers Not Usually Dangerous It is dangerous

When fat is used for energy instead of glucose, a state known as nutritional ketosis develops in the body. Ketones, a chemical byproduct of fat metabolism, are then released into circulation. After then, the ketones may be used by the body as fuel.

Inducing nutritional ketosis is the goal of the ketogenic diet. They do this by consuming a diet heavy in fat but low in carbs. This eating plan has recently gained popularity as a means to reduce body fat and improve health.

Doctors first devised the ketogenic diet to treat epilepsy in youngsters. Eating 3–4 grams (g) of fat for every 1 g of carbohydrate and protein is the "classic" ketogenic diet. Epilepsy Foundation research reveals that more than half of children who take the diet have half as many seizures or less, and 10 to 15 per cent become seizure-free.

The ketogenic diet has been shown to alleviate certain epilepsy symptoms. However, it is unclear why. It has been hypothesized that this diet may also benefit patients with other neurological illnesses, including Parkinson's and Alzheimer's.

Ketoacidosis, on the other hand, develops when the body mistakenly breaks down fats and proteins at an accelerated rate due to a perceived lack of food. Potentially occurring in people with type 1 diabetes, it is a serious complication.

Lack of insulin prevents glucose (blood sugar) from entering cells and being used for energy production; because of this, harmful concentrations of glucose and ketones may build up in the blood. It is known medically as diabetic ketoacidosis.

Ketosis and ketoacidosis are two states that may be differentiated by blood and urine tests administered by doctors.

The usual range of blood ketone concentrations during nutritional ketosis is between 0.5 and 3.0 mmol/L. If your blood glucose levels are above 240 millimoles per deciliter (mg/dl), the American Diabetes Association recommends a ketone test.

People with diabetes with high amounts of ketones in their blood are at a greater risk of developing ketoacidosis.

What Causes Ketosis or Ketoacidosis?

As blood glucose levels drop, a metabolic state known as ketosis sets in. As a result, your body will start using fat for fuel instead of glucose. A low-carb diet is a frequent contributor.

The metabolic state of ketosis is common and typically safe. Proteins and lipids can provide enough sustenance for most people indefinitely. In most cases, if fasting is to blame, the fast will be broken within a fair amount of time.

Ketosis may be dangerous, but it may be more so for those who suffer from eating disorders. After a fast of 12-14 hours, mild ketosis often sets in.

Without food for an extended period, ketosis may progress to ketoacidosis. Nevertheless, this is very unusual and often only occurs in persons whose bodies have a high need for glucose, such as infants, pregnant or nursing women, and athletes. This may occur in the body when famine sets in.

Ketoacidosis Causes

Inadequate control of diabetes is a major cause of DKA. Diabetic ketoacidosis (DKA) occurs when a person with diabetes does not get enough insulin or misses one or more insulin doses.

DKA may also be caused by the body's inability to correctly use insulin because of a disease, infection, or medication. As an example, pneumonia and UTIs are typical causes of DKA.

Possible Dangers

People with and without diabetes are open to entering a state of metabolic ketosis to shed excess pounds. However, those who follow very regimented diets or who suffer from eating disorders run the danger of unintentionally entering ketosis. Low-carbohydrate diets may also put the body into an unnatural ketosis condition.

Diabetic ketoacidosis risk factors consist of the following −

  • Starvation, which results from a lack of food, may cause a metabolic condition called ketoacidosis.

  • Inadequate control of diabetes

  • Heart attack and stroke victims

  • Taking insulin inconsistently or not at all

  • Medications for treating diabetes, including Metformin and antipsychotics, have been shown to affect glycemic control positively.

  • Untreated, undiagnosed type-1 diabetes

  • Those at risk of diabetic ketoacidosis must monitor and control their blood sugar levels. The risk of diabetic ketoacidosis is reduced if they see their physicians routinely.


Upon waking up in the ketosis stage, several people report a fruity, metallic taste in their mouths. It's a good indicator that your body is producing enough levels of ketones. You may check your ketone levels using a breathalyzer, a blood test, or a urine test to ensure your body is in ketosis.

A urine test for ketones may be used to identify diabetic ketoacidosis. Diabetic ketoacidosis is diagnosed when the urine ketone level is over 3 mmol/L. The severity of diabetic ketoacidosis is also related to the amount of acid in the blood. Diabetic ketoacidosis occurs when the plasma glucose level is more than 11 mmol/L, the pH level is less than 7.3, and the bicarbonate level is less than 15 mmol/L.


Medical intervention is unnecessary for those in the ketosis state. When they ingest carbohydrates, they may exit ketosis. Patients with diabetic ketoacidosis need urgent medical care to restore normal blood sugar and ketone levels. To restore the body's electrolyte balance, intravenous fluids and nutrients are given to people with diabetes in ketoacidosis treatment. Diabetic ketoacidosis may be treated with intravenous insulin in rare circumstances. Once again, using glucose as an energy source, insulin assists the body in doing so. As a result, the body will flush out the surplus of ketones.


Ketone production is a hallmark of both ketosis and ketoacidosis. There are, however, several distinctions between the two. Ketosis is a metabolic state your body enters while on a low-carb diet. Ketosis is a weight loss state that is intended to improve health. Nevertheless, increased ketone production and subsequent blood acidity characterize diabetic ketoacidosis. As a result, it causes grave health problems if left untreated. Diabetic ketoacidosis is a potentially fatal consequence of type 1 diabetes.

Updated on: 12-Apr-2023


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