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The result is a rate of ketone production higher than the rate of ketone disposal, and a decrease in blood pH. [12] 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.
Ketoacidosis is most commonly the result of complete insulin deficiency in type 1 diabetes or late-stage type 2 diabetes. Ketone levels can be measured in blood, urine or breath and are generally between 0.5 and 3.0 millimolar (mM) in physiological ketosis, while ketoacidosis may cause blood concentrations greater than 10 mM. [1]
Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis.While ketosis refers to any elevation of blood ketones, ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention.
The concentration of ketone bodies in blood is maintained around 1 mg/dL. Their excretion in urine is very low and undetectable by routine urine tests (Rothera's test). [18] When the rate of synthesis of ketone bodies exceeds the rate of utilization, their concentration in blood increases; this is known as ketonemia.
DKA results from a shortage of insulin; in response, the body switches to burning fatty acids, which produces acidic ketone bodies. [3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH and keto acids in either the blood or urine. [1] The primary treatment of DKA is with intravenous fluids and insulin. [1]
Ketone bodies are elevated in the blood after fasting, including a night of sleep; in both blood and urine in starvation; in hypoglycemia, due to causes other than hyperinsulinism; in various inborn errors of metabolism, and intentionally induced via a ketogenic diet, and in ketoacidosis (usually due to diabetes mellitus).
The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased.
[4] [3] Although, β-hydroxybutyrate is technically not a ketone due to the structure of the molecule (OH- attached to carbonyl group makes this an acid), β-HB acts like a ketone, providing the body with energy in the absence of glucose. [1] In fact, β-Hydroxybutyrate is the most abundant ketone-like molecule in the blood during ketosis. [5 ...