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Nutritional Ketosis vs Diabetic Ketoacidosis

Wondering if your keto diet could push you into ketoacidosis? No worries. In this video, we share the differences between nutritional ketosis and diabetic ketoacidosis…the differences are miles apart!

In the video, you'll learn…

*How nutritional ketosis fuels your organs and ketoacidosis harms them

*Why ketoacidosis is not a concern for non-diabetics

*The range of ketones that determine if a person is in nutritional ketosis or experiencing diabetic ketoacidosis

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More Videos:
5 Keto Tips for The Over 50 Crowd
Top 10 Foods to Get Keto-Adapted Quickly:
Dr. Keith's Complete Transformation:
Definitive Test! What Can I Put in Coffee When Intermittent Fasting?

Disclaimer: Dr. Becky Gillaspy, DC received her Doctor of Chiropractic degree from Palmer College of Chiropractic in 1991. Her use of “doctor” or “Dr.” in relation to herself solely refers to that degree. Dr. Gillaspy was a licensed chiropractor in Pennsylvania, but she no longer practices chiropractic in any state and does not see patients. Dr. Keith Gillaspy, DC, CFMP received his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1991. He also completed 300 hours of post-graduate study resulting in his certification in Functional Medicine. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Gillaspy is a licensed chiropractor in Pennsylvania, and continues to practice in Pennsylvania, and see patients. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Gillaspy and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Dr Becky Fitness LLC and Drs. Rebecca Gillaspy, D.C. and Dr. Keith Gillaspy, D.C. are not liable or responsible for any advice, course of treatment, diagnosis or, any conclusions drawn, services or, product you obtain through this video or site.



  1. Warren Kwok

    The mug tells me another story – NOT an angry old guy. Ketosis changes the way we perceive things, no more bad mood, bad temper is virtually gone. Everything is so calm, peaceful and acceptable. Am I right?

    1. 2 Fit Docs

      Thank you so much! I don’t credit my exercise/activity for my results. I actually maintained my 2-3 times/week at the gym and hockey once a week that I was doing before going keto. 🙂

  2. MJ Hoffman

    Thank you for describing the difference. I have been a T1D for 57 years. Recently a medication addition required a large increase in insulin requirements to maintain control of BG levels. The result was a rapid weight gain with the same amount of food. I read about your method in the past and decided to try it. Carbo levels were reduced to 20% of past levels. Insulin requirements were moved back to previous amounts. I have lost 8 pounds so far. My endocrinologist is very happy with the carb reduction and the lower insulin levels. (I am using my wife’s utube account.)

    Thank you,

  3. Lily T

    I would love it if you would do a video about the ‘keto flu.’ In 2014 I lost fourty pounds doing very low carb (what would now be called keto, though I don’t recall seeing that term very often back then), but leg cramps/ tingling feet, heart palpitations and weakness/dizziness/fatigue kept me from continuing it. I’ve mostly kept the weight off doing moderate low carb, but I still have a lot more weight to lose, so I’ve decided to go back to keto… problem is I’m starting to have the same symptoms.

    Compounding the problem, I’m on a low dose (100 mg spironolactone) of a potassium sparing diuretic (for acne, not blood pressure, so it’s not something I want to get off of), which makes me wary of taking any kind of electrolyte replacements . I realize you can’t comment on me specifically since I have a prescribed medication, but a general video about keto flu would be helpful for a lot of people, I think.

  4. Lisa Darnell

    Since the range of ketosis is 0.5 to 3.0 mmol/L, if my readings are .5 for keto but my glucose reading is 96, can I be in ketosis? How often do you have to measure in order to know that you are in keotosis?

    1. 2 Fit Docs

      Hi Lisa! Technically, you are in nutritional ketosis at .5 or above. Personally, I’m always toward the lower end of ketosis and up to 100 or so glucose so I can be pretty sure that there is no insulin response at that glucose level. I also find that my numbers are worse upon waking and better towards the later afternoon hours. 🙂

  5. Pam

    Hi you two. This is a great video. I’m type 2 diabetic with high insulin resistance that has had high lactic acid levels from metformin and glimerperide. I was on a high dose of metformin for a number of years. Do you think I’m at risk doing keto? My doctor doesn’t really understand about the keto diet or intermittent fasting. At one point I was doing low carb or one meal a day and fasting and I told him my sugars were coming down but I don’t think he believed me. Sorry for rambling, I just really want to get healthy and lower my blood sugars naturally. The only thing I use is long acting insulin and it’s not cutting it. I did go back to eating regular and not keto because of emotional things. I have been taking fat soluble B1 for about a week and a half now up to 600 mgs now split up into 2 doses. At 4am today my blood sugars were 312 I took my b1 and 3 hrs later it was 261 :). Any thoughts or ideas for me? Thank you. Sorry for going on so much.

    1. Kay Derr

      I agree with this because if I were already having “emotional issues,” hearing that I can’t receive any recommendations would certainly not be very motivating. However, there are tons of videos that offer education and training in getting one’s Type 2 diabetes in better control. I’m Type 2 and learning.

    2. antonio ruiz

      Hello There I also am a type 2 diabetic for 19 years and hit the morbidly obese definition awhile back Meaning 100+ pounds overweight and my sugars were horrible in the range of 350 – 480. Eating a ton of crap like pizza chips candy and so on for years..by the miracle of god about 3 months ago I came across intermittent fasting and keto and i tried with many adjustments along the way to lower blood glucose and lose weight so i can stop all the meds i was on for being diabetic..so ive lost 25 pounds which is great but im still struggling to get my sugars under control and what i believe is another cause is i was eating a lot of artificial sweeteners like splenda and using a ton of sugar free creamers with my coffee which i now suspect is causing my numbers to spike still..last few days ive stopped using those with my coffee and switched to stevia and ghee and my numbers are improving…I would say try to go very low carb everyday and fast everyday i do 16-18 hours each day fasting and my eating window is between 6-8 hours per day. I no longer take my metformin and only use insulin if i eat more carbs for certain meals which is rare..check your sugars often when going keto or very low carb as eventually you will need to adjust your insulin to lower doses as i did…its very tough but you can do it a lot of people are in the same situation as we are …Good luck to you

    3. Pam

      Dallas 2018 thank you so much for sharing your experience with me. I appreciate all the encouragement from people. 😊. I definitely want off insulin. Because insulin doesn’t work well either. You are right it makes people heavier. I use only long acting insulin because I tried fast acting humolog and the sliding scale numbers did nothing to bring my numbers down. I get overwhelmed with the whole macros and probably get too much protein 😖

  6. You Tuber

    I am not diabetic, been doing LCHF for 5 weeks, losing lots of weight. Now, bloodwork metabolic panel results great, but show ‘anion gap’ out of range on the high side, chloride barely out of range on the low side. Can these be caused by being in ketosis?

  7. ilovetosew andsew

    Hello, if I eat 50 grams or less of carbs I have noticed my head starts itching and it feels like it’s being bitten and this has woken me up a few times in the night and then I end up with hair coming out, not a massive amount but I don’t like it, if I eat more carbs this doesn’t happen, I have seen a few video’s that are saying you have to eat some glucose for your hair health, do you know if low carb is causing this do you know anyone else who has had the itchy head on ketosis or low carb thanks…

    1. ilovetosew andsew

      Ok thanks, when you type the ketogenic diet and your hair you get allsorts , I don’t get dizzy or headaches or cramps so I didn’t think it would be electrolytes and I eat quite a bit of pink salt, never mind it didn’t itch last night 🙂

  8. Kristyne King

    Huge serious question! I want to recommend this diet to a 24yro type 1 female who is over weight and is extremely junk food addicted. The problem is this needs to be a lifestyle change and her husband is tall and very very skinny. How on earth would this work?

    1. 2 Fit Docs

      Hi Kristyne! It’s tough when family members or a spouse is not involved. That being said, there would be many other health benefits for her husband besides weight loss if he joined her in a keto lifestyle. 🙂

  9. Genny Verdone

    My question..not related to this video…..I want to marinade my chicken thighs with a sauce that has sugar…4 carbs per T. Have you done any studies that show how much sugar is actually absorbed after draining and grilling/baking the thighs? Will it spike glucose?I know I can make my own but this one is tasty, fast and convenient. Thanks for all your hard work and dedication to this keto community.

  10. SouthernRebel

    Hi, I have a close relative that is a type 2 diabetic for many years. Back when he first found out that he’s diabetic, he was experimenting with the Atkins diet. He is absolutely convinced that the low carb diet triggered/caused his diabetes, somehow. Since then he refuses to even consider lowering his carbs. Have you ever heard of such a thing? In your opinion, is that even possible?? Thanks for your input.

    1. 2 Fit Docs

      We have never heard of anything like that and it doesn’t seem very feasible, especially considering the millions of people who have gone low carb in recent years. If anything, the research shows that high carb, processed diets lead to diabetes.

    2. SouthernRebel

      Thanks! I agree. I just wasn’t sure if there’s some mechanism by which having a lot of fat circulating in the blood could send someone who is already prediabetic over the edge into full blown diabetes. I think that’s what he believes.

  11. Michael Ierulli

    I am a cyclist who rides fasted every morning. I usually just drink water but have added electrolytes to my water bottle and understand this will not break a fasted workout. Was wondering if you have any suggestions on a pre-workout drink that would provide energy during a morning workout that wouldn’t break a fast.

    1. 2 Fit Docs

      Hi Michael! As a former cyclist (and trying to back out there), I understand your dilemma. I can remember squeezing a couple of strawberry goo packs into my mouth half-way through a ride. I’ve not tried this myself, but there seems to be a fair number of riders using the keto diet and if you’re game, I’d try MCT oil before a ride. You need to be acclimated before doing this so you don’t end up with “disaster pants” LOL! 🙂

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