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Question:

From Tuscaloosa, Alabama, USA:

I am a Type 2 obese white female diagnosed 4 years ago. In attempts to lose weight on a 1500 calorie ADA diet, okayed by my physician, I have trace to moderate ketones in my urine. I eat appropriate carbs but do watch them, and I an finally losing weight. Is this ketosis dangerous? Is it a sign of something I am not doing correctly? I am asymptomatic but am concerned.

Answer:

Don't be concerned because when you start a low caloric diet, as you're doing with 1500 kcal daily, it is quite normal to observe moderate amount of ketones in the urine due to the metabolic overutilisation of fat storage for energy supply: this overutilisation is what make you losing your extra weight. As a matter of fact, moderate amount of ketones spares also protein loss that accompanies the first period of a low calorie diet.

MS

Additional comments from Dr. Lebinger:

Ketones in the urine signify that you are breaking down fat (losing weight). Although not dangerous in a person without diabetes who is losing weight, ketones in the urine from dieting can be confusing in an individual with diabetes.

In Type 2 diabetes, the individual makes insulin, but the body doesn't respond to it properly (due to insulin resistance). There usually are not ketones in the urine unless the individual is aggressively losing weight. Weight loss may restore the body's normal response to insulin and improve the blood sugars.

It is possible in Type 2 diabetes to lose weight gradually but steadily so that ketones are not produced if there is enough insulin. (If very rapid weight loss with ketones are present, one must be sure not to miss Type 1 diabetes that requires insulin therapy.) Increasing the amount of carbohydrate and decreasing the amount of fat in your diet (without changing the total amount of calories) may help you to continue to lose weight at the same rate but not spill ketones in the urine.

TGL

Original posting 1 Mar 1998
Posted to Meal Planning, Food and Diet

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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