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The symptoms of ketoacidosis are variable depending on the underlying cause. The most common symptoms include nausea, vomiting, abdominal pain, and weakness. [1] [2] Breath may also develop the smell of acetone as it is a volatile ketone that can be exhaled.
Common symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomiting. [7] However, the diagnosis of ketotic hypoglycemia poses a challenge to clinicians, given how nonspecific symptoms can be and given that children in this age range are typically unable to describe their symptoms. [2]
The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. [13] [14] In severe DKA, breathing becomes rapid and of a deep, gasping character, called "Kussmaul breathing".
In the largest trial of the ketogenic diet with a non-diet control, [16] nearly 38% of the children and young people had half or fewer seizures with the diet compared to 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having ...
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Physiological ketosis is the non-pathological (normal functioning) elevation of ketone bodies that can result from any state of increased fatty acid oxidation including fasting, prolonged exercise, or very low-carbohydrate diets such as the ketogenic diet. [5] In physiological ketosis, serum ketone levels generally remain below 3 mM. [1]
In extreme cases the resulting acetone can be detected in the patient's breath as a faint, sweet odor. There are some health benefits to ketone bodies and ketogenesis as well. It has been suggested that a low-carb, high fat ketogenic diet can be used to help treat epilepsy in children. [6] Additionally, ketone bodies can be anti-inflammatory. [19]
Long-term management involves avoidance of fasting (and intravenous glucose in cases of fever or vomiting) and, in children, a mildly restricted protein intake (1.5-2g/kg/day), avoidance of fat-rich (ketogenic) diet, and L-carnitine therapy in those with low carnitine levels.