Are your ketones high? Let's talk about this simply!

Have you ever heard of the word 'Ketones'? If you have diabetes, you may be familiar with the term. Or you may have heard of the 'Keto' diet. What exactly are ketones? Are they good or bad for our bodies? What happens if they increase? Let's talk about all this simply and clearly.

Simply put, what are ketones?

Think of your body as a car. The main fuel for this car to run is glucose. This type of sugar called glucose comes mainly from the foods we eat that contain carbohydrates (e.g. rice, bread, potatoes).

Now think about it, what happens if for some reason the body cannot use this glucose fuel or if it is not enough? Will the car stop? No. Our body is very smart. At that time, the body starts burning stored fat to generate energy. Just like a car running on reserve tank when it runs out of gasoline.

These ketones are released into the blood and travel throughout the body to provide energy to the cells. The remaining ketones are then excreted in the urine.

In fact, it is normal and healthy to have some ketones in our blood, as it is a normal process for our body to use this backup energy source when needed.

But the problem starts when these ketone levels become too high without control. Then our blood becomes too acidic and becomes toxic. We call this ketoacidosis. This is a dangerous condition that requires emergency medical treatment.

When do ketone levels normally increase?

The process of ketone production is called ketosis. This is not a dangerous condition, it's normal. For example, your body's ketone levels may naturally increase slightly in the following situations:

• When you're sleeping: Because you haven't eaten for hours.
• When fasting: The body burns fat because it does not eat.
• When exercising: Because more energy is needed.
• When doing the Keto diet: In this diet, you reduce carbohydrates a lot and eat more fat, so your body gets used to burning fat almost by force.

Who are ketones dangerous for? Diabetes and Ketones

When it comes to ketones, people with diabetes, especially Type 1 Diabetes, should be most concerned about them.

The reason is this. As we discussed earlier, a hormone called insulin helps our body's cells take in glucose (sugar) and use it for energy. A person with type 1 diabetes does not produce this hormone.

So, what happens when you lose insulin?

1. The sugar in the blood cannot enter the cells and accumulates in the blood. This causes the blood sugar level to become very high (`Hyperglycemia`).

2. Because the cells lack energy, the body thinks it is "starving."

3. Build strength, and your body will start burning fat faster.

4. As a result, a very large amount of ketones is formed at once and accumulates in the blood.

5. This high level of ketones causes the blood to become acidic, leading to a dangerous condition called Diabetic Ketoacidosis (DKA) .

Although this condition is more common in people with type 1 diabetes, it can also occur in some cases in people with type 2 diabetes.

Additionally, people who drink excessively are also at risk of developing a similar condition called `alcoholic ketoacidosis`.

What are the symptoms of increased ketone levels? (Symptoms of DKA)

If you have diabetes and experience one or more of the following symptoms, call your doctor immediately or go to the nearest emergency room (ETU). DKA can become very serious very quickly, within 24 hours or less.

How do you check ketone levels?

If you are at risk for DKA, your doctor may recommend a ketone testing kit. You can get it from a pharmacy. It is important to have these at home.

• Blood tests: There are kits you can do at home. Just like checking your blood sugar, you prick your finger with a small drop of blood and put it on a test strip and read it on a meter. This gives you an accurate reading of your ketone levels at that moment. Some glucometers can also check for ketones.
• Urine tests: This involves dipping a test strip into your urine and watching the color change. However, this only tells you what your ketone levels were a few hours ago, not what they are at the moment.
• Breathalyzer tests: These are still a new technology. They are not reliable for someone at risk for DKA. Therefore, they should not be used to measure ketones.

When should ketone levels be checked?

If you have diabetes, your doctor will advise you about this. They usually tell you to check your ketones in the following situations:

• If you have symptoms of DKA.
• If you get sick with a fever, a cold, or have an accident.
• If you miss one or more insulin injections.
• If your blood sugar level is higher than 240 mg/dl.
• If you are pregnant (controlling insulin levels during pregnancy can be challenging).

How to treat elevated ketone levels?

Treatment depends on how high your ketone levels are.

Things you can do at home (only on medical advice)

Your doctor may give you advice on how to manage your levels at home before they become dangerously high. These tips may include:

• The amount of insulin to take.
• Amount of water and food to drink.
• Whether or not it is appropriate to exercise.
• How often should you check your sugar and ketone levels?

Hospital treatment

If ketone levels are very high, hospitalization is necessary. This is where treatment is primarily intravenous saline (IV fluids) and insulin are given to reduce the acidity of the blood and restore ketone levels and sugar levels to normal.

How to prevent DKA and keep ketone levels safe?

If you are at risk for DKA, prevention is the best option. Work with your doctor to do this.

• Maintain a proper routine: Follow your doctor's meal plan and insulin regimen exactly. This will help control your blood sugar levels and reduce the risk of developing ketones.
• Be aware of your levels: Know what your normal ketone levels are, when to check them, and what to do if your levels are high.
• Be prepared: Keep ketone test kits at home. Talk to your doctor and develop a plan to follow if your ketone levels rise. Know exactly what level to talk to your doctor about and what level to go to the ETU.

Most of the time, ketones are a silent help to our bodies. But if you have diabetes, being aware of them and managing your risk could help save your life.

Ketones, Diabetes, DKA, Ketoacidosis, blood sugar, Insulin, keto diet