Don't confuse ketosis with ketoacidosis. Ketoacidosis is a condition usually found in Type I diabetics or very late stage Type 2's in which the feedback loop which normally controls the production of ketones is broken and uncontrolled levels of ketone bodies build up in the blood. From Mosby's Medical Dictionary "acidosis accompanied by an accumulation of ketones in the body, resulting from extensive breakdown of fats because of faulty carbohydrate metabolism. It occurs primarily as a complication of diabetes mellitus and is characterized by a fruity odor of acetone on the breath, mental confusion, dyspnea, nausea, vomiting, dehydration, weight loss, and, if untreated, coma. Emergency treatment includes the administration of insulin and IV fluids and the evaluation and correction of electrolyte imbalance. Nasogastric intubation and bladder catheterization may be required if the patient is comatose. Before discharge of the patient from the hospital, the nurse carefully reviews the meal plan, activity, blood glucose and urine ketone monitoring, and insulin schedule prescribed, emphasizing to the patient that ketoacidosis may be life-threatening and is largely avoidable by strict adherence to the patient's diabetic regimen, monitoring, and appropriate action for illness or stress." Ketosis is the natural process by which fats are metabolized. A pretty good discussion can be found here: webmd.com/diabetes/type-1-diabetes-guide/what-is-ketosis

Since the body needs carbs to convert to glucose for energy and brain function, isn't 45g of carbs a day too low even for a diabetic? Just wondering. My dietician has suggested 30g per meal time, amounting to 90g a day

pseudandry wrote: »

You can find anything on the Internet to support anything you want to support. I'm having trouble finding scientifically-supported information specifically on under-control type 2 diabetes and the effects of ketones. Going into ketosis for type 1 diabetics is not good; going into ketosis for diabetics whose BG is 250-300 or higher is not good; but what about if your daily BG ranges from 80-130 using a low-carb (45g/day or under) food plan?.

This summarizes a number of studies:

http://www.sciencedirect.com/science/article/pii/S0899900714003323

It is an effective way of managing blood glucose levels for many type 2 diabetics, including those whose BG starts at 250 - 300. As others have noted, nutritional ketosis (deriving your energy from fats, rather than carbs) is very different from ketoacidosis (a life-threatening condition).

I immediately changed my diet to fewer than 50 net carbs a day and went from an A1C of 7.2 at diagnosis to an expected A1C of 5.39 (based on an 108 mg/dl average of approximately 350 readings over the past 100 days). I've been over 140 fewer times than I can count on both hands and over 160 only twice since diagnosis, and my average the first week of testing was around 111 (equivalent to an A1c of 5.49).

The blood glucose change was before I lost any weight. I have now lost 34 lbs, but nothing I have seen suggests that losing about 17% of my body weight has had any impact on my insulin resistance (i.e. the same quantity of carbs increases my blood glucose about the same amount for about the same length of time.)

I don't know that I will maintain this diet forever (still looking for long term research - the data is solid on short term use, but mostly absent or not well enough refined for longer term use). But for now, I am very focused on maintaining absolutely normal blood glucose levels. (And secretly hoping that magic will happen and the weight loss will translate into decreased insulin resistance when I lose the other 16% of my original body weight I still need to lose.)