Ketosis Vs. Ketoacidos is When you severely limit your calorie or carb intake, exercise for a very long time or eat a lot of fat, your body breaks down fat and makes ketones. Your brain can use ketones for energy. Interestingly, ketogenic diets have been used to treat children with severe seizures; however, an oft-mentioned criticism of them is the possibility of extreme ketoacidosis. Well, it is true that ketone bodies are acidic, but the ketoacidosis that occurs in diabetics is not the same as what occurs in normal, nondiabetic individuals. Ketoacidosis occurs in type I diabetics when their blood sugar is out of control and they can�t produce insulin. In normal individuals the body regulates ketone levels well enough to meet its fuel needs.

Or perhaps better explained here, at http://wholehealth.homestead.com/report.html

Diet myth: Ketosis is dangerous, ketones building up in the blood lead to acidosis.
There are two types of ketosis which are often confused by those who are uneducated; benign dietary ketosis and ketoacidosis. Dietary ketosis is merely the burning of fat stores and is a natural state which occurs whenever we burn stored fat which can result from diet and exercise. While there are forms of ketosis related to some health problems, benign ketosis is a natural state experienced in fasting, prolonged exercise and high fat diets (41).
The body regulates ketone production so that ketones don't build up past a safe range in healthy individuals, they are also flushed out of the body through the sweat, breath and urine (28).
Many believe that diets high in protein are too acidic and can lead to acidosis. Contrary to this popular myth, meat promotes acid-alkaline balace because it has vitamin D which is essential to this and is a complete protein (34). Most importantly, however, is the fact that proteins act as a buffer for pH (43).

I'm sure that like all popular diet regimens we may see down sides in the future, but I know this much: that ketosis and ketoacidosis are different things. It was confusing at first for me too, mainly because diabetics are encouraged to start a low-carb lifestyle. When I was first diagnosed, I tested for ketones (using a reagent strip that I dip in my urine, see http://www.worldzone.net/health/landmark/ketostix.htm for more information)
and they are either under the categories trace, small, moderate, or large. I had large ketones, which means very bad things are going on in my body, and you usually feel very close to death.

Definition: Diabetic ketoacidosis is a complication of diabetes mellitus caused by the buildup of by-products of fat metabolism (ketones), which occurs when glucose is not available as a fuel source for the body.

Causes, incidence, and risk factors: People with diabetes lack sufficient insulin, a hormone needed to allow the body to use glucose (a simple sugar) for energy. When glucose is not available, body fat is broken down instead. The by-products of fat metabolism are ketones. When fat is metabolized, ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis develops when the blood becomes more acidic than body tissues as a result. Blood glucose levels become elevated (usually higher than 300 mg/dL) because the liver produces glucose to try to combat the problem and because cells cannot take up that glucose without insulin. Diabetic ketoacidosis may lead to the initial diagnosis of type 1 diabetes, as it is often the first symptom that causes the person to come to medical attention. It can also be the result of increased insulin needs in someone already diagnosed with type 1 diabetes. Infection, trauma, heart attack, or surgery can lead to diabetic ketoacidosis in such cases. People with type 2 diabetes usually develop ketoacidosis only under conditions of severe stress. Poor compliance with diet and treatment is usually the cause when episodes are recurrent. Symptoms: Frequent urination or frequent thirst for a day or more,

Fatigue ,Nausea,Vomiting, Muscular stiffness or aching, Mental stupor that can progress to coma
Rapid deep breathing, Fruity breath (breath odor). Additional symptoms that may be associated with this disease: Headache, Consciousness - decreased , Breathing - rapid , Breathing difficulty - lying down

Blood pressure - low, Appetite - loss, Abdominal pain, Signs and tests: Low blood pressure, Rapid heart rate, Signs of dehydration, High blood-glucose (above 300 mg/dL), Presence of glucose and ketones in urine by home or office testing, Serum potassium (may be elevated), Serum amylase (may be elevated)
Arterial blood gas (reveals pH of less than 7.3) This disease may also alter the results of the following tests:

Urine pH, Sodium - urine , Serum sodium, Potassium - urine ,Serum phosphorus, Serum magnesium - test . CSF collection, CO2. Treatment: The goal of treatment is to correct the elevated blood glucose level by giving additional insulin, and to replace fluids lost through excessive urination and vomiting. A person with diabetes may be able to recognize the early warning signs and make appropriate corrections at home before the condition progresses. If ketoacidosis is severe, hospitalization is required to control the condition. Insulin replacement will be given, fluid and electrolytes will be replaced, and the cause of the condition (such as infection) will be identified and treated. Expectations (prognosis): Cell damage from acidosis can lead to severe illness or death. Improved therapy for young diabetics has decreased the death rate associated with this condition. However, it remains a significant risk in the elderly and in people who fall into a profound coma when treatment has been delayed. Complications: Acute myocardial infarction (tissue death) and infarction of bowel tissue due to associated low blood pressure, Renal failure .

Calling your health care provider:his condition can become a medical emergency. Call your health care provider if you notice early symptoms of diabetic ketoacidosis.Go to the emergency room or call the local emergency number (such as 911) if nausea, vomiting, fruity breath, mental stupor, difficulty breathing, or decreased consciousness occur. Prevention: Diabetics should learn to recognize the early warning signs and symptoms of ketoacidosis. Measurement of urine ketones in people with infections or people on insulin pump therapy can give more information than glucose measurements alone.

(excerpted from Medline Plus Medical Encyclopedia http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm)

I guess now is as good a time as any to talk about this. Not everyone gets the same symptoms of hypo or hyper glycemia. Mine are very close to each other, so the only way I can tell which way my blood sugar is going is either a good psychic or a glucometer. The symptoms that I do get usually are that I feel sweaty, verrrrry thirsty (now, I'm not talking about oh, I guess I'd better have a drink...I'm talking about you would lie, cheat, steal, kill for anything that is wet) sometimes I get mental confusion, and sometimes I get this funny feeling...I can't really describe it accurately...just a feeling of 'uh-oh'. When my blood sugar is falling fast, I usually start shaking uncontrollably, and by that point I may not have the mental clarity to think to get something to eat. (one time I jumped out of a moving car and walked about ten blocks to a pizza place, then passed out in their parking lot, I don't really remember much of it though)
For now, my blood sugar is going down. I'm checking it every hour, drinking plenty of fluids, and not moving much. If someone who is in DKA (diabetic ketoacidosis) starts exerting themselves, it creates more ketones, which makes the whole thing much worse. Now, if you are diabetic and you have DKA, I certainly DO NOT recommend staying at home like I am. I know my body, and where I am currently at, I will be okay as long as I stay hydrated, my blood sugar keeps going down, and I am not vomiting or having diarrhea. If any of those things pop up, I will be going down to the ER. It is hard though. I missed a family function today, and I hope they don't think that I am blowing them off. Sometimes people find it hard to understand. Truth is, I never really feel well. I am attached to my meter and insulin 24-7. Being overweight adds to this, because many health care practitioners have the absurd idea that everyone who has diabetes and is overweight has type 2 diabetes. I have type 1. This actually is more than a nuisance, since their misconceptions may cloud their medical decisions, and if I am not in a clear mental state, I can't speak for myself. There is one instance that a doctor's ignorance nearly cost my life. I have the instructions and a web code that they can access my entire medical history online on my medical id bracelet, but they never check it. I can only hope that the doctor who did that is now a little more educated.

Readers are plentiful; thinkers are rare.
~Harriet Martineau

Heather,My husband is 42 (on the 27th) and has had juvenile diabetes since the age of 3, way back in 1964. He wasn't supposed to live past 20's. Hah to them.He can have a bgl of 27 and be lucid, and maybe starting to get a little hungry. He had a stroke in 1999 and in the hospital and in rehab he lost consciousness due to low blood sugar, 31, 28, and by the Grace of God a family member happened in at that moment and called the nurse. If we hadn't????When he gets low, his back sweats. I remember when his sugar was less controlled than now and we were first together I'd wake during the night several times and feel his back. He actually will wake hungry if he's going low and have a snack size candy bar or 2. He recently had a bug of some sort and his sugar was above 280. But being above 400 was once not uncommon for him. Thank God he now stays in the low 200's as his highs, generally.I have a cousin who is learning disabled, adopted from Columbia at age 4 with severe malnutrition and as he grew, several complications from that, including epilepsy and diabetes. He doesn't quite understand and hates rules about his eating/drinking limitations. Or checking his blood sugar. He's just on pills. He was regularly having over 400 and finally one day he was over 500 and the special school he lived at sent him off in an ambulance and my aunt had to be bothered to come down and see about him from about an hour north of Phx. They said they could see 'ick' in the blood drawn and that the blood was practically gelatin like. His main symptom was a terrible stomach ache, and extreme thirst. My aunt now has him in an apt here living on his own and she's moved out of state, and I know he has not changed his behavior. It's frightening, and maddening to see his mom give up on him and do nothing.Thanks for all the info on keto... So far Frank hasn't had any ketone problems....since we've been together, 5 years (we started dating 2 mos before his stroke) he's managed his diabetes much better, we're his health team, and we keep the docs on their toes.Anyway just wanted to share.You're not alone.Hugs, Judy