Atkins Diet Causes Diabetic Ketoacidosis in Diabetes Mellitus Sufferers

Diabetic Ketoacidosis (DKA) is a potentially life-threatening complication for those with diabetes mellitus, and if you’re thinking of trying the Atkins diet, you may encounter this complication.

Diabetic ketoacidosis is a complication predominantly associated with type I diabetes, but it does occur with type II diabetes patients under certain conditions.

Diabetic ketoacidosis complications emerge when the pancreas decreases production of insulin, because the body has no carbohydrates to turn into glucose, and switches to burning fatty acids that produce acidic ketone bodies that cause the symptoms and complications of diabetic ketoacidosis.

Labored breathing, confusion, vomiting and dehydration are typical symptoms of  Diabetic ketoacidosis, and if left untreated, coma and even death can ensue.

Standard symptoms of diabetic ketoacidosis are nausea and vomiting, unquenchable thirst, excessive urine output and abdominal pain. These symptoms usually present themselves over a 24 hour period. If this symptomology is realized, a blood glucose test should be administered, and generally hyperglycemia is indicated.

In some cases diabetic ketoacidosis presents itself as the initial diagnosis for someone not previously known to have diabetes, similar to Diabetic Hyperosmolar Syndrome, but more than likely develops in those persons who already have some form of diabetes.

Diabetic ketoacidosis is less likely to occur in those who have diabetes mellitus type II, and is more common in the African American and Hispanic cultures. This condition is termed “ketosis prone type II diabetes”.

Let me try to explain how the Atkins diet can give someone with type II diabetes mellitus diabetic ketoacidosis, by first explaining ketoacidosis.

Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed when the liver breaks down fatty acids and the deamination of amino acids. Ketoacidosis is a marked state of extreme and uncontrollable ketosis.

Deamination is a process by which amino acids are broken down when there is an excess of protein intake in the body. This may happen when following the Atkins diet plan, which during the initial protocol, the carbohydrate intake is limited to low carbohydrate vegetables for approximately 2 weeks. Because there are no carbohydrates in the body for the liver to produce glucose, which powers our body normally, the liver then begins to break down the fatty acids in your body by the process of deamination, and turns these proteins into glycogen, a secondary, alternate source of energy for the body, stored in the fatty acid deposits of the liver, and to a lesser degree, regular muscle tissue.

When Ketoacidosis happens, the body begins to elevate the level of ketones, because the liver has depleted its reserve of glucose createdglycogen, and now extracts and creates glycogen from the available fatty acids produced by the elevated ketones, in a process called lipolysis. The body then uses this newly created fatty acid glycogen as an alternative source of energy through a process called beta-oxidation.

This is exactly what the Atkins diet does to the human body. By limiting the carbohydrate intake, the body goes into ketosis, and insulin production drops off significantly. The reduced insulin level in the body induces lipolysis, which forces of the liver to create fatty acid based glycogen from the available fatty acids stored in the body, generally in the liver and the muscles.

This is the inherent problem for diabetics with the Atkins diet. This phase, called the induction phase, when carbohydrates are nearly eliminated for two weeks, forces the body to quickly enter a state of ketosis. However for the diabetic, knowing when you’ve reached ketosis and need to begin eating carbohydrates again is the tricky part,  because your insulin production has decreased because of the absence of carbohydrates in the body. It’s at this point when the diabetic needs to resume regular production of insulin, to slow the metabolism of fatty acids based glycogen, which is termed ketosis.

In the non-diabetic patient, the pancreas produces insulin to counteract the fatty acid created ketone/glucose concentration, but the diabetic patient’s pancreatic activity is limited. Additionally, a diabetics bodily organs have become insulin resistant, and require more insulin to service this fatty acid created ketone/glucose concentration.

It is at this point in time when the diabetic experiences insulin deficiency, hyperglycemia and dehydration. Then the lack of insulin in the bloodstream prevents glucose absorption and can cause unchecked ketone production (through fatty acid created metabolism) potentially leading to dangerous ketone and glucose blood levels.

The resulting hyperglycemia creates a glucose overload in the kidneys and spills into the urine. Dehydration then results, following the osmotic movement of water into the urine, exacerbating the acidosis.

Ketoacidosis, ketosis and the other different medical terms I discussed in this article are very hard to explain on their face, and I only hope that I was able to assemble the facts in a more pedestrian manner, as to provide you with an explanation that you can understand, more of a working mans viewpoint of the issue.

The bottom line is this, if you have diabetes mellitus and you want to lose weight, you may find yourself with more problems than you bargained for if you decide to follow the Atkins diet protocol.

If you do have diabetes mellitus and you’re trying to lose weight, the best way to do that would be to just eat healthy, eat more fresh fruits and vegetables and cut down on processed foods and fast food meals, and get a little exercise, even if you just walk around the block every evening.

Article by Jim Donahue

10 Responses to "Atkins Diet Causes Diabetic Ketoacidosis in Diabetes Mellitus Sufferers"

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  6. Lourentia   April 28, 2016 at 6:04 am

    “the liver then begins to break down the fatty acids in your body by the process of deamination, and turns these proteins into glycogen, a secondary, alternate source of energy for the body, stored in the fatty acid deposits of the liver, and to a lesser degree, regular muscle tissue” a mistake – fatty acids are not deaminated.
    If someone eats no carbs, your body will still produce about 130g carbs per day (mainly using fat – ideal in someone with T2D who is obese) – please see critical review published in Nutrition 31 (2015) p.1-13 on using a low carb as first approach in the management of T2D
    Kind regards

  7. puddleg58   October 15, 2015 at 7:39 pm

    P.S. if this warning is based on the theory of DKA rather than the medical record it is misplaced.
    You say “The resulting hyperglycemia creates a glucose overload in the kidneys and spills into the urine.” but an Atkins dieter is going to have lower blood sugar than the same diabetic who is eating carbohydrates.
    The very low carbohydrate for type 1 diabetics is based on the work of Richard K. Bernstein and gives normal blood sugars with a greatly reduced risk of DKA.
    It is similar to the Atkins diet except that protein and carbohydrate is carefully counted to match insulin doses.

  8. puddleg58   October 15, 2015 at 7:32 pm

    Do you have a reference for this?
    I can only find cases of non-diabetics who were using Atkins diet for weight loss and weren’t able to eat because of sickness, and this can happen on any diet you’re not eating.
    I’m trying to find a case of ketoacidosis in a type 2 diabetic using a low carb diet (and actually eating enough of it) but so far no luck.
    Low carb high fat diets were used to prevent diabetic ketoacidosis before the discovery of insulin and had a good record (whereas a carbohydrate diet would cause DKA and the death of the patient).

  9. Wyllis   August 16, 2014 at 7:10 am

    This happened to me and this article saved my life!

  10. Swimmer   December 13, 2012 at 11:55 am

    here’s a reference to the Epilepsy treatment I was talking about


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