Have you ever heard of ketones? Maybe from a doctor, or a friend, or if you are someone who has Diabetes Mellitus, you must be aware of this. Today, we will talk about what these ketones actually are, are they good or bad for our body, and what happens if they increase, in a simple way that you can understand. There is nothing to be afraid of, let's understand everything clearly.
What exactly are ketones?
Simply put, ketones are a type of acid that your body produces. They are produced when your body uses fat instead of glucose for energy. Think about it, our bodies need energy to function. This energy comes mainly from glucose. Glucose is a type of sugar. Our bodies get this glucose from the foods we eat that contain carbohydrates, for example, rice, bread, and potatoes.
Now, if for some reason your body can't get enough glucose for energy, what does it do? It goes to the second option. That is, it burns the fat stored in the body to produce energy. When you burn fat like this, ketone bodies are produced as a byproduct. These ketones accumulate in the blood, travel throughout the body, and provide energy to various tissues. After that, the remaining ketones are excreted in your urine.
Normally, having some ketones in your blood is not a problem, nor is it dangerous. This is because it is normal for our bodies to use fat for energy when needed.
However, if the amount of ketones increases too much, it can be dangerous. Your blood becomes acidic and toxic. This condition is called ketoacidosis. If you have diabetes, you can develop a condition called Diabetic Ketoacidosis (DKA), which is caused by an increase in ketones. This can be life-threatening if not treated properly. So it is very important to be aware of this.
What exactly do ketones do in our bodies?
As mentioned earlier, ketones are a type of energy that provides energy to the brain and body when our body's main source of energy, glucose, is unavailable, low, or unavailable. Think of ketones as your body's "backup power supply." They kick in when the main line is cut.
Normally, glucose is formed from the food we eat, and with the help of the hormone insulin, it enters the cells and produces energy, or is stored for later use.
However, if you don't eat enough carbohydrates, your body goes into a state called ketosis. In this state, the body burns fat for energy, and ketones are released. These ketones provide energy to cells and tissues and help the body function. Ketosis is a normal process. For example:
- While you are sleeping.
- When you are fasting.
- When you exercise.
- When you are on a keto diet.
Let's talk a little about the Keto Diet.
People on the keto diet intentionally reduce their carbohydrates and eat foods that are high in fat. This causes their bodies to burn more fat. There may be some health benefits to achieving ketosis in this way, but it will vary depending on your health condition. Therefore, you should definitely talk to a doctor before starting such a diet. Because it causes major changes in the body, it is not suitable for everyone. Also, the keto diet is a very restrictive diet, so it can be difficult to follow for a long time.
Where are ketones produced?
Ketosis is a process that occurs in your liver . The liver makes ketones and releases them into the bloodstream. These ketones then travel through the bloodstream to provide energy throughout the body. When they are done, they are excreted in the urine.
What medical conditions can be associated with ketones?
Understanding ketones and monitoring your ketone levels is especially important if you have diabetes, especially type 1 diabetes. Type 1 diabetes is a condition in which your body cannot make insulin, a hormone that helps your body use glucose for energy.
When there are problems with insulin, your blood sugar levels can become too high (hyperglycemia), and ketones can build up in your blood. This is what causes diabetic ketoacidosis (DKA). DKA is most common in people with type 1 diabetes, but it can also occur in people with type 2 diabetes.
Additionally, people with alcohol use disorder are at risk for a condition called alcoholic ketoacidosis. People who drink heavily, especially those who have been drinking continuously and vomiting, and who are not eating properly, can develop dangerously high ketone levels. Like DKA, this condition is a medical emergency that requires immediate treatment.
What are the symptoms of high ketone levels?
If you have diabetes and experience the following symptoms, call your doctor immediately, or go to an emergency room (ETU) .
Early symptoms are similar to those of high blood sugar (hyperglycemia):
- Frequent urination.
- Feeling very thirsty.
- Dry mouth and dehydration.
- Dry skin.
- Headache.
If left untreated, DKA can quickly become severe (in 24 hours or less). Symptoms of severe DKA include:
- Nausea and vomiting.
- Extreme fatigue that does not subside even after rest.
- Stomach ache.
- Shortness of breath.
- Confusion.
- A fruity smell to the breath (sometimes called "keto breath").
How do you check ketone levels? What tests are available?
Test kits to check ketone levels are available at pharmacies or can be ordered online. If you are at risk for DKA, ask your doctor which test is best for your health. It is a good idea to have a test kit on hand so that you can act quickly if you notice signs of DKA.
Blood tests
You can get a blood test at a doctor's office, or you can buy a kit that you can use at home. A home kit usually involves pricking your finger with a small needle to get a drop of blood. It's placed on a test strip and read on a meter. The meter's screen shows your current ketone levels.
Some glucometers can measure both blood sugar and ketone levels. If you have one, you don't need to take a separate test.
Urine tests
Urine tests usually involve a test strip. You urinate into a container, stick the strip in it, and wait for it to turn a color. Urine tests have a color chart that shows different levels. You compare the color of your test strip to the color chart.
Unlike a blood test, a urine test can't tell you exactly what your ketone levels are right now . However, it can tell you what your ketone levels have been like over the past few hours .
Breathalyzer tests
Some people on the keto diet use handheld breathalyzers to check their ketone levels. These breathalyzers can detect a type of ketone called acetone. But this technology is still new. Researchers need to study this further before they can be considered reliable and accurate tests.
People at risk of DKA should never rely on a breathalyzer to check their ketone levels.
What do ketone test results mean?
Knowing your ketone levels can help you know if you are at risk for DKA and whether you need to take immediate action to lower your ketone levels. Ketone levels can vary depending on the test you take. Also, what is considered normal or high ketone levels can vary from person to person.
The table below provides a general guide to what your blood ketone levels mean in relation to your risk of DKA, and what actions you should take. (See your doctor for specific advice on this.)
- Usually less than 0.6 mmol/L: This is a normal level.
- 0.6 to 1.5 mmol/L: Your ketone levels are a little high. Follow your doctor's instructions. They may ask you to test again in a few hours.
- 1.6 to 2.9 mmol/L: Your ketone levels are high. You may be at risk for DKA. Call your doctor immediately.
- 3.0 mmol/L or higher: Your ketone levels are very high. You need immediate medical attention. Go to a hospital immediately.
When should you check your ketone levels?
If you have diabetes, your doctor will advise you on when and how often to check your ketone levels. They will tell you to check at these times:
- When you have symptoms of DKA.
- Even when you are sick or injured.
- If you have missed one or more insulin injections.
- If your blood sugar level is higher than 240 mg/dl (milligrams/deciliter).
- If you are pregnant. (Managing insulin levels during pregnancy can be a bit challenging. If you have diabetes, you need to be especially careful about your insulin and ketone levels during pregnancy.)
What happens if ketone levels rise?
As mentioned earlier, if ketone levels are high, your blood can become too acidic and toxic. This is what happens in ketoacidosis. Diabetic ketoacidosis (DKA) is the most common type of ketoacidosis.
What are the treatments for elevated ketone levels?
Treatment depends on how high your ketone levels are. Your doctor will guide you through steps you can take at home to lower your levels before they become dangerously high. They may advise you to do things like:
- The amount of insulin to take.
- The amount of food to eat and water to drink (and what kind of food).
- Safe activity level.
- How often should I check my blood sugar and ketone levels?
- At what blood sugar and ketone levels should you see a doctor (or go to the ER)?
Treatment in the hospital includes giving IV fluids and insulin to lower your ketone levels.
How to keep ketone levels in a safe range?
If you think you are at high risk for DKA, work with your doctor to take steps to prevent it.
- Maintain a daily routine that helps you control your ketone levels. Get into a routine that keeps your blood sugar levels within a safe range and insulin levels in check. This will reduce your risk of high ketones. Talk to your diabetes doctor to decide what is safe.
- If you use an insulin pump, talk to your diabetes care team about how to prevent DKA. Understanding how your pump delivers insulin, how to recognize a pump malfunction, and having an emergency plan can help reduce the risk of DKA when using an insulin pump.
- Know your levels (and when to test). Know what your normal ketone levels are and when to take steps to lower them. Talk to your doctor about when you should test your ketones (for example, if you have an injury or infection).
- Be prepared. Keep a ketone test kit handy if you have symptoms of DKA. Work with your doctor to make a plan for what to do if your ketones get too high. It's important to know when to call your doctor and when to go to the ER right away.
Finally, things to remember
Most of the time, ketones are a silent helper when our bodies can't get enough energy from glucose. However, if your ketone levels are high and you have a condition like Type 1 Diabetes, you need to be especially concerned about them. Talk to your doctor about what to do if your ketone levels are high. Make a plan to keep your ketones at a safe level to avoid complications like DKA. Your health is in your hands!
` Ketones, diabetes, ketoacidosis, DKA, blood sugar, energy, fat burning
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