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Ketosis

A condition characterized by an abnormally elevated concentration of KETONE BODIES in the blood (acetonemia) or urine (acetonuria). It is a sign of DIABETES COMPLICATION, starvation, alcoholism or a mitochondrial metabolic disturbance (e.g., MAPLE SYRUP URINE DISEASE).

Also Known As:

Acetonemia; Acetonuria; Ketoacidemia; Ketoaciduria; Ketonemia; Ketonuria; Acetonemias; Acetonurias; Ketoacidemias; Ketoacidoses; Ketoacidoses, Metabolic; Ketoacidosis, Metabolic; Ketoacidurias; Ketonemias; Ketonurias; Ketoses, Metabolic; Ketosis, Metabolic; Metabolic Ketoacidoses; Metabolic Ketoses; Ketoacidosis; Metabolic Ketoacidosis; Metabolic Ketosis

Networked: 2424 relevant articles (95 outcomes, 162 trials/studies)

Relationship Network

Disease Context: Research Results

Nutritional and Metabolic Diseases: 2
- Metabolic Diseases: 3200
  - Acid-Base Imbalance: 87
    - Acidosis: 11068
      - Ketosis: 2424
        Diabetic Ketoacidosis: 1525

Related Diseases

1.	Hyperglycemia
2.	Ketosis
3.	Hypoglycemia (Reactive Hypoglycemia)
4.	Acidosis
5.	Type 1 Diabetes Mellitus (Autoimmune Diabetes)

Experts

1.	Umpierrez, Guillermo E: 11 articles (11/2014 - 03/2004)
2.	Wang, Zhe: 9 articles (03/2015 - 03/2008)
3.	Fukao, Toshiyuki: 8 articles (02/2015 - 12/2004)
4.	Cunnane, Stephen C: 8 articles (04/2013 - 01/2002)
5.	Liu, Guowen: 7 articles (03/2015 - 12/2010)
6.	Kitabchi, Abbas E: 7 articles (04/2010 - 03/2004)
7.	Balasubramanyam, Ashok: 6 articles (09/2015 - 05/2007)
8.	Jain, Sushil K: 6 articles (03/2015 - 07/2002)
9.	Gautier, Jean-François: 6 articles (01/2015 - 03/2004)
10.	Li, Xiaobing: 6 articles (06/2014 - 12/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Ketosis:

1.	Insulin (Novolin)FDA Link 04/01/2010 - "Near-normoglycemia remission in obese African American patients with KPD and ketosis-resistant type 2 diabetes is associated with a remarkable recovery in basal and stimulated insulin secretion. " 04/01/2010 - "Most patients with ketosis-prone type 2 diabetes (KPD) discontinue insulin therapy and remain in near-normoglycemic remission. " 03/01/2010 - "CONCLUSIONS Near-normoglycemia remission in obese African American patients with KPDM and ketosis-resistant type 2 diabetes is associated with a remarkable recovery in basal and stimulated insulin secretion. " 01/01/2014 - "Ketoacidosis was managed by insulin and insulin daily requirement began to dwindle after one month, until its complete withdrawal at 8 weeks, when partial remission was reached. " 04/01/2007 - "This therapy improved quality of life in these patients due to a significant reduction of hypoglycemic (including severe) events, ketosis episodes and total daily insulin dose, with important impact on health public services."
2.	Glucose (Dextrose)FDA LinkGeneric 04/01/2008 - "Once the diagnosis of alcoholic ketoacidosis is made, the mainstay of treatment is hydration with 5% dextrose in normal saline. " 08/01/1981 - "The modes are interconvertible, because fasting will transform modes 1 or 2 into mode 3, while administration of either glucose, propionate, or glucocorticoid will, on the basis of at least one index, transform modes 2 or 3 into mode 1. It is concluded that a) carbohydrate sufficiency is jeopardized in lactating cows, and b) one reason for the therapeutic efficacy of antiketogenic agents used in the treatment of bovine ketosis is the ability of these compounds to increase carbohydrate sufficiency." 03/01/2010 - "At remission, KPDM and ketosis-resistant type 2 diabetes had similar glucose (94 +/- 14 vs. 109 +/- 20 mg/dl), A1C (5.7 +/- 0.4 vs. 6.3 +/- 1.1%), and baseline AIR(arg) response (34.8 +/- 30 vs. 64 +/- 69 microU/ml). " 02/01/2009 - "Ketosis was not completely eliminated in the glucose-added arm." 09/01/1999 - "Ketosis was eliminated with glucose, 60 g/d. "
3.	Blood Glucose (Blood Sugar)IBA 01/01/1992 - "The high mean blood glucose and ketosis indicate a relatively severe metabolic decompensation at the time of diagnosis and call for further improvement in the diagnostic acumen of the pediatric community." 11/01/1982 - "The children with remission had lower blood glucose, milder hyperketonemia and ketonuria, higher pH and PCO2 at onset than those without remission. " 12/01/2015 - "After prolonged preoperative fasting, children younger than 36 months can present with ketoacidosis and (low) normal blood glucose concentrations. " 02/01/2015 - "However, in spite of high blood glucose levels, patients rarely develop ketosis. " 11/01/2014 - "HbA1c and blood glucose levels and ketoacidosis frequency was found significantly changed (p<0.05). "
4.	C-PeptideIBA 01/01/2014 - "Ketosis onset group had increased plasma C-peptide levels at 0 h, 0.5 h, and 3 h and higher AUC(0-0.5), AUC₀₋₁, AUC₀₋₃ (P < 0.05). " 09/01/2011 - "The classical presentation includes rapid onset on ketosis within 1 week of symptoms of hyperglycaemia, with a near-normal glycohaemoglobin and absence of C-peptide. " 12/01/2008 - "Compared to patients with Ab(-) T2D, those with CPH-Ab(+) T2D had lower BMI, lower fasting C-peptide (FCP) levels, and more frequent ketosis, while not as much as did those with GAD-Ab(+) T2D. " 01/01/2003 - "The patients with fasting C-peptide at the onset below normal range (<0.28 pmol/ml) were at high risk of ketoacidosis, OR (95%CI)=3.3 (1.3-8.2). " 01/01/2003 - "In the group of patients with ketoacidosis lower C-peptide level and lower c-peptide/glycaemia ratio than in children without ketoacidosis were observed (0.20+/-0.18 vs. 0.31+/-0.28 pmol/ml and 0.07+/-0.05 vs. 0.20+/-0.17, p<0.003, respectively). "
5.	3-Hydroxybutyric Acid (beta-Hydroxybutyric Acid)IBA 10/01/1993 - "To avoid the potential confounding effect of increased ketone levels (beta-hydroxybutyrate was approximately 170% higher in the pregnant rats), experiments were repeated in the nonfasting state when ketosis was eliminated in both groups. " 01/01/2010 - "The first objective of this study was to investigate the relationship between concentrations of beta-hydroxybutyrate (BHBA) in milk and blood to assess the reliability of the BHBA concentrations in milk measured by a semi quantitative keto-test paper to detect subclinical ketosis (SCK) in 50 fresh high-producing Iranian Holstein cows in Golestan Province, Iran. " 04/28/2001 - "This study was to establish enzyme-rate method for determining serum beta-hydroxybutyric acid, and to discuss its meaning in diabetes ketosis acidism. " 02/01/1998 - "The objective of this study was to evaluate the characteristics of five ketone tests for use with milk to detect subclinical ketosis [defined as > 1200 mumol of beta-hydroxybutyrate (BHBA)/L of blood] in dairy cows. " 04/01/1990 - "The effect of D-(-)-beta-hydroxybutyrate, at concentrations commonly achieved during ketoacidosis in humans (10 mmol/l), on human fat cell lipolysis in vitro was the aim of this study. "
6.	Glucagon (Glukagon)FDA Link 01/01/2013 - "Ketosis-prone atypical diabetes: glucagon is there, too." 01/01/2005 - "High glucagon is said to be necessary for ketosis in severe forms of diabetes. " 07/01/2004 - "This may indicate that factor (s) other than substrate and esterification is (are) probably involved in the ketosis resistance of FCPD and LIS subjects; and (d) Although FCPD and LIS differ regarding generalized pancreatic damage (which raises the possibility of involvement of glucagon producing alpha-cells in the FCPD group) the two groups do not differ regarding the ketogenic substrate and esterfication responses." 01/02/2000 - "It is well-known that fasting accelerates development of lipolysis and ketosis and increases glucagon levels. " 07/01/1986 - "The ketosis was reversed by glucagon administration. "
7.	HormonesIBA 08/15/2012 - "The objectives of this study were to compare cytokine and hormone concentrations in dogs with DKA before and after resolution of ketoacidosis, to compare these concentrations before treatment of DKA to those measured in dogs with uncomplicated DM and healthy dogs, and to compare concentrations in dogs with uncomplicated DM to those measured in healthy dogs. " 12/01/2003 - "These synthetic hormones are employed for therapeutic purposes against inflammatory reactions, disorders of the musculoskeletal system, bovine ketosis and many other diseases of farm animals. " 06/01/2000 - "During therapy, levels of counterregulatory hormones declined at similar rates and returned to normal values after resolution of ketoacidosis. " 06/01/2000 - "We aimed to determine differences in pathogenesis of ketoacidosis and its metabolic consequences by comparing both at presentation and during treatment, the different metabolic products and hormones involved in the ketoacidotic state. " 04/01/2000 - "It is hypothesized that TM produces changes in pituitary hormone secretion by enhancing hypothalamic GABAergic tone as a result of TM associated ketosis. "
8.	KetonesIBA 08/01/1988 - "Thus, the inability of exercise to enhance the metabolic clearance of ketones at high physiological plasma ketone levels is a general phenomenon that applies to both endogenous and exogenous ketosis." 10/01/2009 - "It is concluded that supplementing PG as a dry product via incorporating into the TMR is as effective as when used as a top dress, based on the efficacies of both delivery methods to numerically reduce urine ketones concentrations and, therefore, the incidence for subclinical ketosis during the first 21 days of lactation. " 01/01/2014 - "She exhibited ketoacidosis and a remarkably strong ion gap, except for ketones. " 01/01/2014 - "The patients were divided into ketosis-resistant diabetes (KRD), DKWA and DKA groups on the basis of urinary ketones, blood pH and bicarbonate levels. " 12/01/2013 - "The final multivariable regression model for urine osmolality included USG and the presence of ketones; ketonuria had a small negative association with urine osmolality. "
9.	Monensin (Coban)IBA 09/01/2015 - "Efficacy of controlled-release capsules containing monensin for the prevention of subclinical ketosis in pasture-fed dairy cows." 11/01/1998 - "Efficacy of monensin for the prevention of subclinical ketosis in lactating dairy cows." 02/01/1989 - "The addition of 30 g monensin/ton of feed decreased the incidence of subclinical ketosis from 6 out of 12 to 1 out of 12. " 01/16/2006 - "The objective of this study was to determine the effect of a monensin controlled-release capsule on the proportion of cows with subclinical ketosis (SK). " 09/01/2015 - "To determine the effectiveness of intra-rumenal controlled release capsules (CRC) containing 32 g of monensin administered pre-calving to reduce the cumulative incidence of subclinical ketosis (SCK) in mainly pasture-fed dairy cows. "
10.	Hemoglobins (Hemoglobin)IBA 12/01/2000 - "four groups of patients were studied, comprising 19 patients with DKA, massive ketonuria and plasma standard bicarbonate levels below 16 mmol/l (group 1); 20 patients with poorly controlled diabetes, glycated hemoglobin (HbA1c) above 8% and plasma bicarbonate levels above 16 mmol/l (group 2); 11 patients with well-controlled diabetes and HbA1c below 8% (group 3); and 10 non-diabetic, non-obese control subjects (group 4). " 04/01/1996 - "A highly significant inverse correlation was observed between the change from baseline condition to ketosis of the ratio C20:4/C20:3, the product/precursor ratio for the reaction catalyzed by delta5-desaturase, and the values of hemoglobin A1c,(r = -0.855; P = 0.0015). " 03/17/1988 - "The major differences between the 27 patients with remission and the 13 without remission were the duration of symptoms before diagnosis (26.8 vs. 48.0 days, P less than 0.01), the degree of weight loss (3.2 vs. 10 percent of body weight, P less than 0.001), the initial hemoglobin A1c level (10.7 vs. 13.2 percent, P less than 0.001), and the frequency of ketoacidosis (11 vs. 61.5 percent, P less than 0.001). " 01/01/2006 - "Insulin pump therapy is effective in lowering glycated hemoglobin levels without higher risk of severe hypoglycaemia and ketoacidosis. " 08/01/2015 - "A serum chemistry panel, a glycated hemoglobin test, and urinalysis performed at presentation revealed elevated blood glucose and glycated hemoglobin (HbA1c) levels (727 mg/dL and 10.1%, respectively), glucosuria, and ketonuria. "

Therapies and Procedures

1.	Ketogenic Diet 11/01/1999 - "These results suggest that the efficacy of the ketogenic diet is independent of the level of ketonemia but is markedly influenced by diet and growth." 01/01/2015 - "To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, we conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analogue scales before (in energy balance) and during (while in ketosis) adherence to VLED or KLCD. " 04/01/2011 - "Our Italian collaborative study group was set up in order to formulate a consensus statement regarding the clinical management of the ketogenic diet, patient selection, pre-ketogenic diet, counseling, setting and enforcement of dietary induction of ketosis, follow-up management, and eventual discontinuation of the diet." 01/01/2015 - "Ketogenic diets like low carbohydrate, high fat may induce ketoacidosis. " 01/01/2015 - "Ketosis, ketogenic diet and food intake control: a complex relationship."
2.	Diet Therapy (Therapy, Diet) 01/01/2007 - "A consistently strong ketosis (beta-hydroxybutyrate of >3 mmol/L) seemed to be important for maintaining the efficacy of the diet therapy. " 11/01/1999 - "Diet therapy improved ketosis without insulin therapy in a case of anti-GAD65+ diabetes." 02/01/2000 - "Subjects included 18 nondiabetic obese adolescents, 12 obese adolescents with type 2 diabetes on diet therapy, 10 obese adolescents with type 2 diabetes manifesting ketosis at onset or with a history of treatment with hypoglycemic agents, and 26 non-obese adolescent control subjects. " 05/01/2004 - "Compared with patients using insulin therapy, patients using oral hypoglycemic drugs or diet therapy showed higher BMI (at onset of ketosis (25.69+/-2.66) kg/m2 vs. (22.64+/-3.75) kg/m2, P=0.001; during follow-up period (26.19+/-3.11) kg/m2 vs. (22.29+/-2.97) kg/m2, P=0.000), higher post-load serum insulin level (at onset of ketosis (32.39+/-35.87) mU/L vs. (18.53+/-14.43) mU/L, P=0.017; during follow-up period (67.34+/-68.42) mU/L vs. (36.40+/-45.39) mU/L, P=0.004), lower HbA 1C (at onset of ketosis (10.76+/-1.25) percent vs. (12.04+/-1.99) percent, P=0.006; during follow-up period (6.97+/-1.31)percent vs. (9.36+/-3.18) percent, P=0.000), higher percentage of ICA and GAD positivity (at onset of ketosis, ICA positive rate was 18.52 percent vs. 0, P=0.030, GAD positive rate was 18.52 percent vs. 0, P=0.030; during follow-up period, ICA positive rate was 7.41 percent vs. 0, P=0.111, GAD positive rate was 14.81 percent vs. 0, P=0.022). "
3.	Parenteral Nutrition 09/01/2012 - "Although a brief span of several days, all patients could maintain ketosis and the efficacy of the previous enteral KD during the ketogenic parenteral nutrition. " 09/01/1990 - "In this case, iv MCT proved to be a relatively safe and effective short-term method of continuing parenteral nutrition while maintaining ketosis for seizure control." 09/01/2012 - "The ketogenic parenteral nutrition proved to be a relatively safe short-term method of continuing KD to maintain ketosis for seizure control, while patients were unable to absorb nutrients through their intestinal tract."
4.	Injections 01/01/2015 - "The cows of subclinical ketosis were evenly allocated to either the treatment group (daily injections, 0.3 mg BI 14332/kg body weight, 7 days) or the control group. " 02/01/2000 - "The most commonly reported falsified or induced conditions were fevers, ketoacidosis, purpura, and infections, and the fabrications ranged from false symptom-reporting to active injections, bruising, and ingestions. " 11/01/2015 - "To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI). " 06/01/1997 - "Severe diabetes, if not controlled by periodic insulin injections, can lead to ketoacidosis and death. " 04/11/1995 - "Patients need to be controlled by periodic insulin injections to prevent the development of ketoacidosis, which can be fatal. "
5.	Cesarean Section (Caesarean Section) 10/01/2001 - "This resulted in maternal ketoacidosis and a non-reassuring fetal heart rate trace for which caesarean section was considered. " 12/01/1983 - "Diabetic mothers experienced significantly higher prevalences of cesarean section and ketoacidosis than did the overall population. " 10/01/2001 - "Cessation of steroids and aggressive management of ketoacidosis resulted in improved maternal and fetal condition without the need for emergency caesarean section." 07/01/2012 - "The aim of the present study was to evaluate whether fasting may cause changes in maternal lipid profile, glucose level and ketonuria, and whether it has any adverse effects on fetal Doppler, birthweight, preterm delivery or cesarean section rate. "