Diabetic ketoacidosis is not caused by simple elevation in ketones. It is a whole cascade of events that starts with either lack of insulin or severe insulin resistance and continued high carb consumption.
Blood glucose over 13 (240mm/dl), and no insulin or severe insulin resistance (body doesn't listen to insulin) is what starts ketoacidosis. Think of it as an endocrine system storm. Ketoacidosis is a part of this whole storm, but is not the problem itself.
What happens: Elevated blood glucose (to the point where it is spilling into the urine, damaging the body tissues). Body goes into damage control: releasing calories from fat (ketones) into the blood stream because the sugar isn't usable, either insulin isn't there or body isn't using the insulin anymore. There is an increased production of insulin counter regulatory hormones. Catecholemines, cortisol, glucagon, growth hormone levels increase.
Telling the liver to take up glucose and store it because we are damaging the body with this much of this sweet stuff circulating. Body's ability to buffer the blood decreases under this abnormal metabolic state; kidneys are not working properly. Liver is working hard to mop up sugar. The breathing changes to get rid of some of the acids. The ketoacidosis is simply the final diagnosable stage of the severe diabetic storm. They can smell the ketones coming out of you. But the ketones are not the problem themselves. They are the body's attempt to stay alive in an extreme emergency.
Because we are not consuming heavy amounts of carbs that our body cannot deal with due to lack of insulin or insulin resistance our system does not go into an emergency state. We have ketones in our blood stream and in our urine but don't have dangerous amounts of sugar in our blood stream.
We have gradually transitioned from sugar use to ketone use. If you don't have excessive carbs in your diet, a ketoacidosis storm cannot happen.
We have started working on correcting the underlying cause of the insulin resistance and are in nutritional Ketosis.
By Sarah Robinson