I am confused about ketoacidosis and weight loss. How can a person who has diabetes and wants to lose weight not experience ketoacidosis? Does a normal person experience ketoacidosis if they burn fat in a weight loss regimen? Is ketoacidosis burning too much fat too quickly?

I suspect you are mixing up DKA [diabetic ketoacidosis] and ketosis. Ketones are produced by the body whenever fat is burned (catabolized) for any reason. Ketosis normally occurs during starvation, with insulin deficiency that is otherwise uncorrected or during illness when insulin needs increase. Any weight loss that is sustained will be associated with ketosis. Such ketosis does not become ketoacidosis since most people don’t have diabetes (insulin deficiency).

Ketoacidosis is an exaggerated response to insulin deficiency, and so is a dangerous potential situation for anyone with diabetes. Ketoacidosis involves not only insulin deficiency but also high blood glucose levels. The body switches to fat metabolism and thus produces excessive amounts of ketones which can be measured either with urine or blood levels of ketones (acetone, acetoacetate and beta hydroxybutyric acid). This progresses to severe dehydration, water and salt imbalance, acid-base imbalance and coma and death if unrecognized or untreated.

Weight loss can be accomplished in people with diabetes by paying close attention to activity (increasing activity), decreasing total calorie intake and re-balancing insulin or other medications taken as part of diabetes treatment.

SB