
Introduction
In recent years, the ketogenic diet (keto) has become increasingly popular as a weight-loss measure and lifestyle choice. For those unfamiliar with this eating plan, it involves a high-fat, moderate-protein, super-low-carb (less than 20 g per day) diet that forces the body to utilize fat instead of glucose for energy. But there is an immense amount of misinformation out there about the safety of this popular diet. One of the most persistent rumors is that a keto diet could lead to ketoacidosis.
But can the keto diet cause ketoacidosis? The answer is complicated and the answer may vary depending on who you talk to. To get to the bottom of the myth, let’s start by taking a look at what exactly ketoacidosis is and whether a keto diet could potentially put you at risk. In this blog post, we will be unpacking the myth that a keto diet leads to ketoacidosis and exploring the truth of the matter.
What Is Ketoacidosis?
Ketoacidosis is a metabolic disorder that occurs when the body produces a high ketone levels and blood becomes too acidic. This condition is commonly seen in people with diabetes, especially those with type 1 diabetes, as well as those with alcoholism and starvation. In diabetic ketoacidosis, the body is unable to use glucose as a source of energy due to a lack of insulin, so it begins to break down fat instead. This results in the production of ketones, which are acidic byproducts that can accumulate in the bloodstream and lead to ketoacidosis. Symptoms of ketoacidosis include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, shortness of breath, confusion, and fatigue. If left untreated, ketoacidosis can be life-threatening and may lead to coma or death.
Treatment for ketoacidosis involves addressing the underlying cause and correcting the acid-base balance in the body. In cases of diabetic ketoacidosis, insulin therapy is required to lower blood sugar levels and prevent further ketone production. Fluid and electrolyte replacement is also necessary to correct dehydration and electrolyte imbalances. In severe cases, hospitalization may be required for close monitoring and management of the condition. With prompt and appropriate treatment, most people with ketoacidosis can recover fully and avoid serious complications. It is important for individuals with diabetes to monitor their blood sugar levels regularly and seek medical attention immediately if they experience symptoms of ketoacidosis.
Who is at Risk for DKA?

DKA, or diabetic ketoacidosis, is a dangerous and potentially life-threatening condition that can occur in individuals with diabetes. While it is more commonly seen in individuals with type 1 diabetes, it can also occur in individuals with type 2 diabetes under certain circumstances.
The following factors can increase the risk of DKA:
- Insulin deficiency: DKA is most commonly seen in individuals with type 1 diabetes, as they have an absolute insulin deficiency due to the destruction of insulin-producing cells in the pancreas. However, individuals with type 2 diabetes who are on insulin therapy can also be at risk if they do not take their insulin as prescribed.
- Illness or infection: Illness or infection can cause the body to produce more stress hormones, which can increase blood glucose levels and decrease insulin sensitivity, leading to DKA.
- Inadequate insulin therapy: Inadequate insulin therapy, whether due to incorrect dosing or missed doses, can lead to high blood glucose levels and the production of ketones.
- Dehydration: Dehydration can occur due to illness, insufficient fluid intake, or excessive urination, and can increase the risk of DKA.
- High blood glucose levels: Prolonged high blood glucose levels can lead to the production of ketones and increase the risk of DKA.
It is important for individuals with diabetes to monitor their blood glucose and ketone levels regularly, especially during times of illness or stress, to reduce the risk of DKA. Additionally, individuals on insulin therapy should ensure they are taking their insulin as prescribed and consulting with a healthcare professional if they experience any concerning symptoms.
How Does the Ketogenic Diet Relate to Ketoacidosis?
The ketogenic diet, also known as the keto diet, is a low-carbohydrate, high-fat diet that aims to put the body into a state of ketosis. This is achieved by significantly reducing the intake of carbohydrates and increasing the consumption of fats, which forces the body to use fat as its primary source of energy instead of glucose is also very high. As a result, ketones are produced and used for energy, leading to weight loss and other health benefits. However, there is a common misconception that the keto diet can lead to ketoacidosis, which is a dangerous condition.
In reality, the risk of developing ketoacidosis while following the keto diet is very low for most people. This is because the body is still able to regulate its acid-base balance and maintain normal blood pH levels. The levels of ketones produced on the keto diet are also much lower than those seen in diabetic ketoacidosis. However, it is important to note that individuals with certain health conditions, such as type 1 diabetes, may be at a higher risk of developing ketoacidosis while following the keto diet. It is therefore recommended that anyone considering the keto diet consult with a healthcare professional first, especially if they have a pre-existing medical condition.
Is the Keto Diet Safe for Everyone?

While the keto diet can be safe and effective for many people, it may not be suitable for everyone. Individuals with certain medical conditions, such as liver or pancreatic disease, may need to avoid the keto diet or consult with a healthcare professional before starting it. Additionally, pregnant or breastfeeding women should also avoid the keto diet, as it may not provide sufficient nutrients for fetal development or milk production.
Another potential risk of the keto diet is that it can lead to nutrient deficiencies, particularly in vitamins and minerals that are typically found in carbohydrates. To minimize this risk, it is important to include a variety of nutrient-rich foods in the diet, such as leafy greens, non-starchy vegetables, and healthy fats like avocado and nuts. It may also be beneficial to supplement with vitamins and minerals, especially if following the keto diet long-term.
As with any diet, it is important to listen to your body and adjust accordingly, and to consult with a healthcare professional if you have any concerns about your health or nutritional status.
How to Reduce the Risk of Ketoacidosis
While the risk of developing ketoacidosis on the keto diet is low for most people, there are some steps that can be taken to further reduce this risk. First and foremost, it is important to monitor blood sugar levels regularly, especially for individuals with diabetes. This can help detect any abnormalities or warning signs of ketoacidosis early on. Additionally, staying well-hydrated is important, as dehydration can increase the risk of developing ketoacidosis. Drinking plenty of water and other fluids, and avoiding excessive alcohol consumption, can help prevent dehydration.
It is also important to ensure adequate protein intake, as consuming too little protein can lead to muscle loss and increased production of ketones. However, consuming too much protein can also have negative effects on the body and may increase the risk of ketoacidosis. Therefore, it is recommended to consult with a healthcare professional or registered dietitian to determine the appropriate protein intake for your individual needs. Finally, it is important to listen to your body and watch for any signs or symptoms of ketoacidosis, such as excessive thirst, frequent urination, nausea, and fatigue. Seeking medical attention promptly if any of these symptoms develop is crucial to prevent serious complications.
Ketosis vs. Ketoacidosis: Understanding the Difference
The ketogenic diet has gained popularity in recent years for its potential health benefits, including weight loss and improved blood sugar control. However, there are concerns about the safety of this diet and whether it can lead to a condition called ketoacidosis. In this article, we’ll take a closer look at the difference between ketosis and ketoacidosis and whether the ketogenic diet can cause ketoacidosis.
Ketosis | Ketoacidosis |
---|---|
A metabolic state in which the body burns fat for fuel instead of carbohydrates. | A serious medical condition occurs when there is an excessive buildup of ketones in the blood. |
Can be achieved through a low-carb, high-fat diet such as the ketogenic diet. | Occurs primarily in people with type 1 diabetes who have insulin deficiency. |
Has been shown to have various health benefits, including weight loss, improved blood sugar control, and reduced inflammation. | Can be life-threatening if left untreated. Symptoms include nausea, vomiting, confusion, and dehydration. |
Ketone levels in the blood are typically in the range of 0.5-3.0 mmol/L. | Ketone levels in the blood are typically above 10.0 mmol/L. |
Considered a natural and safe metabolic process. | Considered a medical emergency that requires immediate treatment. |
While ketoacidosis is a serious medical condition that requires immediate attention, it is not a concern for most people who follow a ketogenic diet. By understanding the difference between ketosis and ketoacidosis, you can make informed choices about your dietary and health decisions. As always, it’s important to consult with a healthcare professional before making any major dietary changes.
FAQ
What happens to the body during ketosis?
During ketosis, the body switches from using glucose as its primary source of energy to using ketones produced from fat. This can lead to weight loss, improved insulin sensitivity, and other health benefits.
What are the symptoms of being in ketosis?
Common symptoms include increased thirst, frequent urination, dry mouth, bad breath, and a decrease in appetite.
How long does it take to get into ketosis?
It can take several days to a week or more to get into ketosis, depending on individual factors such as carbohydrate intake and physical activity level.
What is ketoacidosis?
Ketoacidosis is a dangerous condition in which there are high levels of ketones and acid in the blood, leading to a decrease in blood pH levels. It is most commonly seen in individuals with uncontrolled diabetes.
How do ketosis and ketoacidosis differ?
While both involve the production of ketones, ketosis is a natural metabolic process that occurs when the body is low on glucose, whereas ketoacidosis is an abnormal and potentially life-threatening condition that occurs when there is a buildup of ketones and acid in the blood.
Why is ketosis dangerous for diabetics?
While ketosis itself is not dangerous for diabetics, it can increase the risk of diabetic ketoacidosis, a dangerous and potentially life-threatening condition in which there are high levels of ketones and acid in the blood.
Does being in ketosis (not ketoacidosis) cause kidney damage?
For most people, being in ketosis does not cause kidney damage. However, individuals with pre-existing kidney conditions should consult with a healthcare professional before following a keto diet, as it can increase the workload on the kidneys.
Conclusion
The keto diet can be a safe and effective way to achieve weight loss and improve overall health for many individuals. However, it is important to consider individual factors and potential risks before starting the diet, and to consult with a healthcare professional if necessary. Additionally, taking steps to reduce the risk of ketoacidosis, such as monitoring blood sugar levels, staying hydrated, and ensuring adequate protein intake, can help ensure a safe and successful experience on the keto diet.