Ketosis

A metabolic state in which the body primarily uses fat-derived substrates for energy instead of glucose, characterized by increased fatty acid oxidation and accumulation of ketone bodies (acetoacetate, β-hydroxybutyrate, and acetone) in the blood and tissues due to reduced carbohydrate availability or impaired insulin action.

Causes

• Dietary causes

  • Fasting

  • Starvation

  • Malnutrition

  • Prolonged calorie restriction

  • Low-carbohydrate or ketogenic diets

  • Prolonged or intense exercise

• Uncontrolled diabetes mellitus, especially type 1 diabetes

  • Reduced insulin availability

  • Increased counter-regulatory hormones (glucagon, cortisol, adrenaline, GH)

• Metabolic acidosis

  • Diabetic ketoacidosis (DKA)

  • Alcohol-related ketoacidosis

  • Severe illness or infection

• Medications: SGLT2 Inhibitors

• Other causes

  • Prolonged vomiting

  • Pregnancy-associated ketosis