Defining Ketones and the Ketogenic Diet

Photo credit Phil Gladwell via flickr CC 2.0

Photo credit Phil Gladwell via flickr CC 2.0

What are ketones?

Ketones occur when the body can no longer break down any carbohydrate, so it needs to use its stored fat to help. They are small molecules made primarily of acetone that can be dangerous if ignored.

Why do we check for ketones?

Ketones are especially dangerous for those of us living with type 1 diabetes because it means there is little to no insulin in our blood cells and these ketones end up pouring in to our urine and can affect our kidneys. For those of us who use an insulin pump with only short or rapid-acting insulin, if our pump malfunctions and we are sleeping, our body can form ketones more easily because we do not have any long-acting insulin on board to back us up.

How do we check for ketones?

Ketones can be checked in two different ways. Urine testing and using a blood meter. Ketone urine strips come in a bottle and are available from your diabetes doctor. Within 60 seconds or less, you’ll be able to see whether or not you have ketones in your body based on the color-coded strip usually on the bottle or box. Just keep in mind that like your vial of insulin, the ketone strips do expire.

Ketone Strip

Blood ketone testing is done similarly to a blood glucose fingerstick except the number read will determine the level of ketones in your blood. This too is available via prescription from your doctor.

Regardless of your preferred method of ketone testing, make sure you have a plan in place with your healthcare team about ketones and how to handle them. For me personally, I can physically tell when I have ketones, but I remember attending summer camp as a child, and every time my blood sugar was above 240 mg/dl having to make the trek to the infirmary and wait for the “pee lady” to tell me whether I had them or not. If I did, I had drag around a gallon of water to help flush out the ketones.

Why all the buzz around ketones?

Recently on Glu and other diabetes outlets, there has been talk about the ketogentic diet. On Glu we don’t endorse one diet or another, but what is the fuss all about?

A ketogenic diet is a high fat and low-carbohydrate diet where the body ends up burning fat for fuel rather than carbohydrates. Usually this diet contains less than 50 grams of carbohydrates per day. The liver then converts fat into fatty acids and ketone bodies. These ketone bodies make their way up to the brain and are used as an energy source instead of glucose.

This diet has been known to treat epilepsy since the 1920s and continues to find a role in epilepsy management today.

For people with type 1 diabetes, this diet would reduce the amount of insulin one would take, but that correlation (less insulin) does not mean better glucose control. People with type 1 diabetes often worry about ketones, especially with the very dangerous diabetic ketoacidosis (DKA), which results from a shortage or absence of insulin. With nutritional ketosis, is it very different from DKA, especially when is insulin present.

To make a long story short, nobody likes ketones, wishes they had them, and certainly can’t describe how they feel having them unless you’ve been one of the unlucky people to experience them. Make sure you talk to your doctor about how to manage them!

Anna Floreen–GluAnna

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