How To Avoid Ketoacidosis

How To Avoid Ketoacidosis

Avoiding ketoacidosis is especially important for people with diabetes, but even those on ketogenic diets should be aware of the condition. Here’s what you need to know:

🔍 What Is Ketoacidosis?

Ketoacidosis—especially diabetic ketoacidosis (DKA)—is a dangerous buildup of ketones and acid in the blood, often caused by low insulin and high blood sugar. It’s life-threatening and should not be confused with nutritional ketosis, which is a safe, mild elevation of ketones from a low-carb diet.

⚠️ Who Is Most at Risk?

• People with type 1 diabetes (most common)
• People with type 2 diabetes (less common, but possible)
• Anyone with insulin deficiency
• Rare: Alcoholics, or people with prolonged starvation, severe infections, or uncontrolled vomiting

✅ How To Avoid Ketoacidosis

1. Monitor Blood Sugar Regularly

• Keep blood sugar in the target range (usually 70–180 mg/dL, but follow your doctor’s advice).
• Use a continuous glucose monitor (CGM) or check with a glucometer.

2. Never Skip Insulin (if prescribed)

• If you have type 1 diabetes, missing insulin is the #1 cause of DKA.
• Continue taking insulin even when you’re sick or not eating—adjust doses under medical supervision.

3. Stay Hydrated

• Dehydration worsens ketone buildup.
• Drink enough fluids daily, especially if you’re ill, exercising, or on a keto diet.

4. Monitor Ketones (If Diabetic)

• Use urine ketone strips or a blood ketone meter.
• Check ketones if:
  • Your blood sugar is >250 mg/dL
  • You’re sick, stressed, or have an infection
  • You feel nauseous, have abdominal pain, or feel fatigued

Seek emergency help if ketones are high and you’re feeling ill.

5. Avoid Very-Low-Carb Diets If Diabetic Without Medical Advice

• Nutritional ketosis from keto diets is not the same as ketoacidosis.
• But if you’re insulin-dependent, a keto diet can be risky without doctor-supervised insulin adjustments.

6. Manage Infections and Stress

• Illness increases insulin needs.
• Have a “sick day plan” with your healthcare provider, including how to adjust meds and when to go to the ER.

🚨 Warning Signs of Ketoacidosis

If you notice these symptoms—seek medical help immediately:

• Fruity-smelling breath
• Rapid breathing
• Nausea, vomiting
• Extreme fatigue
• Confusion
• Abdominal pain
• High blood sugar AND high ketones

Summary: Safe Ketosis ≠ Dangerous Ketoacidosis

Nutritional Ketosis	Diabetic Ketoacidosis
Controlled ketones (0.5–3 mmol/L)	Very high ketones (>10 mmol/L)
Safe and intentional	Medical emergency
Normal blood sugar	Very high blood sugar
Feel energetic	Nausea, confusion, fast breathing