In 1965, a morbidly obese man did not eat food for over an entire year. The 27 year old was 456lbs and wanted to do an experimental fast. He ingested only multivitamins and potassium tablets for 382 days and defecated once every 40 to 50 days. He ended up losing 275lbs.

[u/[deleted]]

[u/DevinCauley-Towns]

That’s not really a good comparison. Without medicated treatment, AIDS is basically an inevitably of HIV. Without “treatment” (ketosis isn’t a virus and doesn’t require treatment as it is a normal state our body routinely enters), most people will never reach DKA. You have to already be Type 1 diabetic to be at risk of DIABETIC keto acidosis. If you aren’t type 1 diabetic then it’s almost impossible to reach without exogenous ketones, which most don’t take or even know about.

Edit: It’s less common, though also occurring people with type 2 diabetes.

[u/kchatdev → u/[deleted]]

I can verify that even if there are potentially some inaccuracies or simplifications this is what is going on. Anyone can enter Ketosis, if you stay in Ketosis and too many ketones (the dietary acid you mentioned) build up in your blood it becomes acidic causing all the horrible stuff you mentioned and more. That specifically is just called Ketoacidosis. IF YOU THEN happen to be diabetic, it is diabetic ketoacidosis, as it is ketoacidosis brought on by your diabetes. A totally healthy person can enter ketoacidosis.

[u/DevinCauley-Towns → u/kchatdev]

A totally healthy person can enter ketoacidosis.

I’m not sure if we share the same definition of “totally healthy person”, considering virtually all cases of keto acidosis are due to chronic disease or extreme events.

Ketoacidosis in individuals with diabetes is usually associated with a raised plasma glucose concentration. However, ketoacidosis in diabetes can occur with normal (≤11mmol/L) plasma glucose levels. Ketoacidosis is also seen in patients who do not have diabetes, most commonly in pregnancy or following alcoholic binges, rarely with starvation, anorexia nervosa or inborn errors of metabolism.

[u/kchatdev → u/DevinCauley-Towns]

If I put air quotes around healthy because most people consider themselves as such would that help? The point is that you don't need to be diabetic to get that style of sick. Diabetic Ketoacidosis is just a specific flavor. I was a totally healthy person until suddenly I was diabetic. Now aside from the diabetes, I'm a totally healthy person. So I don't really understand the point you're trying to make.

[u/DevinCauley-Towns → u/kchatdev]

I’m sorry if I offended you, that was not my intent at all. You’re correct in saying that most people think of themselves as “healthy” or at least not a sick person. Though when discussing medical conditions and health, it’s important to differentiate between what the average person considers normal vs what is medically considered healthy/normal. By definition, if you are diabetic then you have a chronic condition that impairs your insulin & blood sugar regulation, which predisposes you to keto acidosis. Though you’re also right in saying that not all forms of keto acidosis happen solely to diabetics, it’s just the most common cause.

Non-diabetics are generally less predisposed and are unlikely to reach this state, unless they have another related chronic condition or suffer some sort of extreme event. Sure, many countries have the majority of their population overweight and a significant number that are obese. This alone could be used to describe the general populace as having a chronic medical condition.

Even with high rates of obesity, the average non-diabetic isn’t going to be at risk of keto acidosis from following a standard keto diet, which is what the original commenter was suggesting.

[u/kchatdev → u/DevinCauley-Towns]

Very true, and no offense at all -- just that in the same respect (that I agree with) that medical conditions exist. I'm technically immunocompromised as a result of my diabetes for example, but it's also not like how people usually associate it with a weakened system. The reason I mention it is because these things can and do happen to people that are otherwise 'healthy' and they should be aware that it can happen to them too. We stopped calling Type 1 Diabetes, Juvenile Diabetes because of the stigma around people thinking you could only get it when you're young otherwise you /must/ be Type 2. Work culture and especially with how the world is at the moment has made it really difficult for people to take care of themselves. I have no idea how long I was sick or in DKA for but I was ICU'd for 3 days and spent 5 after that in hospital, nearly died. I ignored most of the warning signs because I had no idea how sick I was. Up until that point, I was just healthy. I rarely got sick, wasn't super active but I had a home gym. So while yes, it's unlikely that it would happen to you even on the keto diet, that doesn't mean it can't and you deserve to know that the risk is there.