Is The Keto Diet Safe? A Functional Doctor Weighs In

It’s important to note the difference between nutritional ketosis and a dangerous condition called ketoacidosis. Ketosis is a natural process created within the ketogenic diet when the body shifts from a glucose-burning state to a fat-burning state. Diabetic ketoacidosis is an extremely dangerous metabolic state when the ketone levels rise to an unnaturally high level. This is most commonly seen in people with mismanaged type 1 diabetes. Diabetes type 1 is an autoimmune condition that causes the immune system to attack the beta cells of the pancreas; these are the cells that produce insulin. Damage to these cells will compromise insulin production or completely eliminate the production of insulin. If a person is unable to make insulin, they become insulin dependent and need to administer pharmacological insulin to prevent ketoacidosis. 

Poor management of type 1 diabetes is one of the leading causes of ketoacidosis. In insulin-dependent diabetics, unless they inject insulin, there is no brake to stop the production of ketones. The ketones rise to dangerous levels, creating acidity in the blood, which can be life-threatening. This is not a ketogenic diet problem; this is a lack of insulin problem. This is virtually impossible in a person with a properly functioning pancreas.

Other factors that increase the risk for ketoacidosis in a person with type 1 or type 2 diabetes include developing an infection, abusing drugs or alcohol, or taking a medication that affects how your body uses sugar. For example, corticosteroids, which are used for inflammatory bowel conditions and respiratory conditions like asthma, can make it harder for your cells to use insulin. Other medications, such as diuretics, can also raise blood glucose levels.

Symptoms of diabetic ketoacidosis include:


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