Ketosis Vs. Ketoacidosis: What’s The Difference?

  • Author: Kara
  • Date: August 21, 2023
  • Time to Read: 13 min.
Affiliate Disclaimer

The Keto Eater is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to

Hey there, fellow keto enthusiasts! If you’re on this journey with us, then it’s likely that you’ve heard about ketosis and how it can help your body burn fat for fuel. However, there’s another term out there that sounds similar but is actually quite different: ketoacidosis. Ketosis and ketoacidosis are two very distinct states of being that happens in the body when we eat a low-carb diet. While one can be beneficial to weight loss and overall health, the other can be life-threatening if left unchecked.

Disclosure: Some of the links in this article may be affiliate links, meaning that we may earn a small commission if you click through using our link and make a purchase.  Please be assured that this will not cost you any extra money. Also, please be assured that we either use the products we recommend personally, or have been recommended by trusted friends who currently use them.

In this article, we’ll dive into the differences between these two metabolic states so you can better understand what they mean for your own ketogenic lifestyle.

So grab a glass of water (or maybe some bone broth), get comfortable, and let’s explore ketosis vs. ketoacidosis together!

What Is A Keto Diet?

The keto diet is a high-fat, low-carbohydrate eating plan that aims to put the body into a state of ketosis. This metabolic state occurs when the body burns fat for fuel instead of carbohydrates.

The benefits of the keto diet are numerous. It can lead to significant weight loss, improved blood sugar control, improved sleep, and decreased inflammation, amongst many other benefits.

However, there are also risks associated with this way of eating. Some people may experience side effects such as fatigue or headaches, while others may struggle to stick to the restrictive food choices.

Despite these potential challenges, you will find many success stories within our community from those who have made lasting lifestyle changes by adopting a keto diet approach.

What Is Ketosis?

Ketosis is a metabolic state where the body uses fat for energy instead of carbohydrates.

It’s important to recognize the signs and symptoms, as well as the potential causes and benefits of ketosis, to maximize the positive effects.

Common signs of ketosis may include bad breath, increased urination, and fatigue.

Causes of ketosis may include a ketogenic diet, fasting, and exercise.

The benefits of ketosis include increased energy, weight loss, and improved mental clarity.

Signs And Symptoms Of Ketosis

It is important to understand the signs and symptoms of ketosis. While there are many benefits to entering this metabolic state such as weight loss, improved mental clarity, and increased energy levels, there can also be some side effects that may arise.

Some common signs of being in ketosis include a decrease in appetite, an increase in thirst and urination, bad breath (also known as ‘keto breath’), and a change in body odor.

Additionally, those who are new to the ketogenic diet may experience flu-like symptoms known as the ‘keto flu’ during the transition period into ketosis.

It’s important to note that these symptoms are typically temporary and will subside once your body adjusts to using fat for fuel instead of carbohydrates.

Causes Of Ketosis

Now that we’ve covered the signs and symptoms of ketosis, let’s dive into what causes this metabolic state.

Ketosis is primarily caused by a lack of carbohydrates in the body. When carbohydrate intake is restricted, the liver begins to break down stored fat into molecules called ketone bodies. These ketones are then used as fuel instead of glucose from carbohydrates.

Other factors that can lead to ketosis include fasting for prolonged periods without food, intense exercise, and certain medical conditions such as diabetes or alcoholism.

It’s important to note that while some may intentionally enter ketosis through diet or lifestyle changes, others may experience it unintentionally due to these underlying factors.

Regardless of how you enter into this metabolic state, understanding its causes and symptoms can help you better navigate your keto journey and make informed decisions about your health.

Benefits Of Ketosis

So now that we’ve covered the causes of ketosis, let’s dive into the benefits of this metabolic state.

While research is ongoing, many have reported experiencing decreased appetite, increased satiety, and improved blood sugar control while following a keto diet.

Additionally, some studies suggest that ketosis may also have neuroprotective properties and could potentially benefit those with certain neurological conditions.

With all these potential benefits, it’s no wonder why so many people are turning to the ketogenic lifestyle as a way to improve their health and well-being.

Metabolic Pathways:

Ketone metabolism is the process of breaking down fatty acids into ketone bodies, which can then be used by the body as an alternative fuel source when glucose is scarce.

Gluconeogenesis is the process of synthesizing glucose from non-carbohydrate sources like amino acids and glycerol, which can help to maintain blood sugar levels when glucose stores are depleted.

Ketone Metabolism

As we have already been through, ketones are produced when the body breaks down fat for energy in the absence of glucose. This process occurs during periods of fasting or carbohydrate restriction, such as with a ketogenic diet.

Insulin regulation plays a key role in this metabolic pathway, as high insulin levels inhibit ketone production and low insulin levels promote it.

It’s crucial to note that while ketosis is a natural and healthy state for the body to enter into, ketoacidosis is a dangerous condition that can occur in individuals with uncontrolled diabetes or alcoholism.

As such, monitoring blood glucose and ketone levels is essential for those following a ketogenic lifestyle.


Now that we have discussed the basics of ketone metabolism, let’s delve into another crucial aspect of metabolic pathways: gluconeogenesis.

Gluconeogenesis is the process by which the body produces glucose from non-carbohydrate sources such as amino acids and glycerol.

This process plays a vital role in maintaining blood glucose levels during periods of fasting or low carbohydrate intake.

It’s essential to understand how gluconeogenesis benefits our bodies while following a ketogenic lifestyle.

By knowing more about this metabolic pathway, we can better optimize our diets for maximum health benefits.

So, let’s explore how gluconeogenesis works in the body!


Glycolysis is the pathway by which glucose is broken down to produce energy.

This process is essential for the production of ATP, the body’s main energy source.

It’s also heavily regulated to ensure the proper balance between ketosis and ketoacidosis.

Ketosis is a natural state of metabolism that occurs when the body produces ketone bodies as an alternative energy source while ketoacidosis is a serious complication of diabetes which is caused by an excess of ketone bodies in the blood.

Energy Production

Now that we’ve cleared up any confusion between ketosis and ketoacidosis, let’s dive deeper into the topic of energy production.

In order to understand how ketogenic diets work, it’s important to have a basic understanding of glucose metabolism. When you consume carbohydrates, they are broken down into glucose molecules which your body uses for energy.

However, when you restrict carbohydrates in your diet, your body turns to alternative sources of fuel – namely, fat. As I mentioned earlier, this process leads to the production of ketone bodies by the liver through gluconeogenesis and ketogenesis.

But how exactly does this process lead to weight loss?

Well, when your body is in a state of ketosis and producing ketone bodies for energy instead of relying on glucose from carbohydrates, it has no choice but to burn stored fat as its primary source of fuel. This results in increased fat burning and ultimately a reduction in body weight.

It’s also worth noting that there are other potential benefits associated with using ketones for energy production beyond weight loss alone, this is why some people will try and get into ketosis as quickly as possible.

Some research suggests that they may improve cognitive function and offer neuroprotective effects against certain diseases such as Alzheimer’s.

Overall though, while the science behind ketogenic diets can seem complex at first glance, once you grasp the basics of glucose metabolism and the role of ketone bodies in energy production everything starts to make sense!


Now that we have a good understanding of how energy production works in the context of ketogenic diets, let’s shift our focus to the regulation mechanisms involved in glycolysis.

In the case of glycolysis, these mechanisms involve various enzymes and hormones that work together to regulate glucose uptake and utilization by cells throughout the body.

By understanding these regulatory processes, we can gain a deeper appreciation for how ketosis impacts our metabolism on both a cellular and systemic level.

So let’s dive into the fascinating world of glycolysis regulation!

What Is Ketoacidosis?

Ketoacidosis is a dangerous medical condition that can arise due to uncontrolled ketone production in the body.

It is most commonly seen in individuals with diabetes, especially those who are not managing their blood sugar levels properly.

When insulin levels are low and glucose cannot enter cells for energy, the body starts breaking down fats into ketones as an alternative source of fuel.

However, if too many ketones build up in the bloodstream, they can become toxic and lead to ketoacidosis.

Causes of ketoacidosis include illness or infection, missed doses of insulin or other medications used to manage diabetes, drug or alcohol abuse, and high stress levels.

Symptoms typically develop rapidly and may include excessive thirst and urination, fatigue, nausea and vomiting, abdominal pain, confusion or difficulty concentrating, fruity-smelling breath odor, and even loss of consciousness.

Complications from untreated ketoacidosis can be life-threatening and require urgent medical attention.

Diagnosis: Blood tests will usually show elevated blood glucose levels along with high levels of ketones.

Management: Treatment involves correcting fluid imbalances through intravenous fluids while also restoring electrolyte balance (potassium) to normal ranges.

Insulin therapy aims at reducing blood glucose levels by increasing cellular uptake of glucose.

Overall it’s important to remember that prevention is key when it comes to avoiding ketoacidosis – this means careful monitoring of blood sugars and adherence to prescribed medication regimens.

If you experience any symptoms associated with this potentially deadly complication of diabetes it is imperative that you seek emergency help right away!

How Do Ketosis And Ketoacidosis Feel?

Physical symptoms can be different between ketosis and ketoacidosis. In ketosis, physical symptoms may include weight loss, increased energy levels, and improved mental clarity. These benefits are often why people choose to follow a ketogenic diet in the first place.

However, it’s important to note that some people may experience short-lived negative side effects such as bad breath odor, or constipation.

On the other hand, ketoacidosis is a serious medical condition that occurs when there are high levels of ketones and blood sugar in the body.

Symptoms of ketoacidosis can include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, confusion, and even coma.

It’s crucial for individuals with diabetes or any underlying health conditions to monitor their blood glucose levels closely while following a ketogenic diet to avoid developing ketoacidosis.

How To Tell The Difference?

It’s important to understand the differences between ketosis and ketoacidosis, including the symptoms and diagnosis for each.

Knowing these distinctions can help you identify when to seek medical attention.


Generally, those in ketosis may experience some mild symptoms such as fatigue or headaches during the adaptation phase.

On the other hand, those with diabetic ketoacidosis (DKA) will typically present with more severe symptoms including abdominal pain and vomiting.

Check out this article for more on keto terms.

Long-term effects of sustained DKA can be life-threatening, so it’s crucial to recognize these symptoms early on and seek medical attention immediately if necessary.

Remember, monitoring your body’s response to ketogenic diets is key to staying healthy and safe!


Now that we’ve covered the symptoms of ketosis and diabetic ketoacidosis, let’s talk about diagnosis.

If you’re experiencing any of the severe symptoms mentioned earlier or have risk factors such as type 1 diabetes, it’s important to seek medical attention immediately.

Your doctor may order blood tests to check your glucose and ketone levels to determine if you’re in ketosis or DKA.

Prevention is key when it comes to managing these conditions, so make sure to monitor your body closely and communicate any concerns with your healthcare provider.

Remember, taking action at the first sign of symptoms can save your life!

Why Do Ketosis And Ketoacidosis Happen?

Just like how a car engine works, the human body needs fuel to function. And just like how cars have different types of fuel that it can run on, humans also rely on different sources for energy.

While most people get their energy from glucose or carbohydrates, some individuals turn to ketones produced by the liver when there isn’t enough sugar available in the bloodstream. This metabolic state is known as ketosis.


  • Low-carb diet
  • Prolonged fasting
  • Intense exercise


  • Increased thirst and urination
  • Dry mouth
  • Bad breath with fruity smell

Prevalence: Ketosis is common among those who follow low-carbohydrate diets such as the ketogenic diet.

Risk factors: People with diabetes who take insulin or other medications that lower blood sugar levels may be at risk of developing ketoacidosis if they experience prolonged periods of high blood sugars.

Complications: In rare cases, severe untreated ketosis can lead to dehydration, confusion, coma or death. Therefore it’s important to monitor your symptoms and seek medical attention if necessary.

Can Someone With Diabetes Be In Ketosis Without Being In Ketoacidosis?

For people with diabetes, managing blood glucose levels is a top priority. Nutritional ketosis can be an effective way to manage diabetes by improving insulin sensitivity and reducing the need for medication.

But what about the risk of ketoacidosis? Can someone with diabetes be in ketosis without being in danger of this dangerous condition?

The answer is yes – as long as they carefully monitor their ketone levels. Ketoacidosis occurs when ketone levels become dangerously high, causing blood pH to drop and leading to potentially life-threatening complications.

However, nutritional ketosis typically results in lower but still beneficial levels of ketones that do not pose a risk for those with well-managed diabetes. Regular monitoring of blood glucose and ketone levels can help individuals safely achieve nutritional ketosis without risking ketoacidosis.

Can A Ketogenic Diet Cause Ketoacidosis?

As we discussed earlier, individuals with diabetes can be in ketosis without being in ketoacidosis. However, it is important to note that a ketogenic diet can still pose risks for those with diabetes and other medical conditions.

It’s crucial to maintain nutritional balance while following a ketogenic diet and monitor any symptoms closely. Diabetic implications of a ketogenic diet include the risk of hypoglycemia (low blood sugar levels) if insulin dosage isn’t adjusted appropriately.

Additionally, there may be an increased risk of diabetic ketoacidosis if ketone levels become too high. Symptom identification is key in preventing serious complications, such as nausea, vomiting, confusion, or extreme thirst. In these cases, medical intervention should be sought immediately.

Overall, a ketogenic diet can provide many health benefits but must be approached carefully by all individuals and especially so for diabetics or anyone with underlying medical issues.

How Can Ketoacidosis Be Prevented?

Preventing Ketoacidosis is essential for individuals on a ketogenic diet, especially those with diabetes. Diabetic management can be challenging and requires close monitoring to prevent ketoacidosis from occurring. Nonetheless, there are nutritional strategies and lifestyle changes that one can make to reduce the risk of developing this severe condition.

Managing ketosis correctly is crucial in preventing ketoacidosis. It involves balancing macronutrients while maintaining a low-carb intake to ensure that the body remains in a state of mild ketosis. Monitoring blood glucose levels regularly helps identify any fluctuations or imbalances that may lead to ketoacidosis.

Here are some tips on how you can prevent ketoacidosis:

  • Stay hydrated: Drinking enough water helps maintain electrolyte balance and prevents dehydration.
  • Monitor Ketone Levels: Using urine or blood test strips will help track your ketone levels so that you can adjust your diet accordingly.
  • Keep A Balanced Diet: Ensure that your meals contain sufficient protein, healthy fats, leafy greens, and other nutrient-dense foods
  • Seek Medical Attention If Symptoms Persist: In case of persistent symptoms such as nausea, vomiting or abdominal pain seek medical attention immediately.

Implementing these simple steps into your daily routine will go a long way in preventing ketoacidosis. By managing your diabetic condition through proper nutrition and lifestyle changes, you can enjoy all the benefits of being in ketosis without worrying about potential complications.


As the old adage goes, prevention is better than cure. This holds particularly true for ketosis and ketoacidosis. While both conditions require proper treatment, preventing them from happening in the first place should be a top priority.

Treatment options vary depending on the severity of the condition. For mild cases of ketosis or early stages of ketoacidosis, medication management may suffice to bring down blood sugar levels to normal range.

However, more severe cases of ketoacidosis may require hospitalization and intensive care with therapeutic interventions such as intravenous fluids and insulin therapy.

Additionally, lifestyle changes including increased physical activity and dietary modifications such as reducing carbohydrate intake are effective ways to prevent these conditions from occurring again in individuals who have already experienced them.

It’s important for those at risk for developing ketosis or ketoacidosis – especially people living with diabetes – to work closely with their healthcare provider to create an individualized plan that incorporates preventative measures alongside appropriate medical intervention when needed.

Wrapping Up: Ketosis Vs. Ketoacidosis

As a keto expert, it is important to understand the difference between ketosis and ketoacidosis.

Ketosis is a natural metabolic process where your body burns fat for fuel instead of glucose. This can be achieved through following a ketogenic diet or fasting.

On the other hand, ketoacidosis is a serious medical condition that occurs when there are high levels of ketones in the blood, often seen in individuals with uncontrolled diabetes. It can lead to coma or even death if left untreated.

It’s crucial to note that while someone on a ketogenic diet may experience mild symptoms of ketosis such as bad breath or increased thirst, they will not enter into ketoacidosis unless they have an underlying health issue like uncontrolled diabetes.

In order to prevent the dangerous effects of ketoacidosis, it’s essential for people with diabetes to closely monitor their blood sugar levels and seek immediate medical attention if they suspect they are experiencing symptoms.

As always, consult with a healthcare professional before starting any new dietary regimen.

Remember, while ketosis can have many benefits for weight loss and overall health, it’s important to prioritize safety above all else. Don’t let confusion over these two terms deter you from exploring the potential benefits of a ketogenic lifestyle.

Leave a Reply

Your email address will not be published. Required fields are marked *

Skip to content