In both T1 and T2 diabetes, patients have abnormal insulin signaling. In T1, the pancreas doesn’t make enough insulin, and in T2, the body’s tissues are resistant to insulin. Insulin helps transport glucose from the blood into the cells where it can be used for energy. In severely uncontrolled diabetes (typically someone not being treated for their condition), insulin signaling is wildly impaired, and an acute and life-threatening condition called ketoacidosis can occur. If a person is eating a standard diet wherein carbohydrate is a major portion of their macronutrient intake, their tissues are mostly burning glucose for fuel. Therefore, if insulin signaling is incredibly impaired, this will cause glucose to build up in the blood because it can’t get into the cells. Thus, the cells are basically starving even though there’s plenty of glucose in the blood. (This is sometimes referred to as “starvation in the land of plenty.”) This causes the liver to begin making ketones from stored fats, just as it would if you were starving from not eating anything. Insulin also plays a role in regulating ketone production, and normally it inhibits ketone production if it’s too high to keep ketones at a proper level in the blood. So, if the patient’s diabetes is too severely uncontrolled, it is possible that a situation called “runaway ketogenesis” occurs. The liver makes lots and lots of ketones in a short amount of time. Ketones are acids, and when at extremely high levels (typically >20mM), they can cause blood pH to drop, which can be very dangerous and/or fatal. This is diabetic ketoacidosis.
Is being in therapeutic ketosis itself dangerous for a diabetic? No. There is substantial scientific evidence to suggest that consuming a ketogenic diet could actually be a very good treatment for diabetes, perhaps also exogenous ketones. Many individuals are even able to go off insulin once they switch to a ketogenic diet because it takes away the real culprit (carbs). Ketones don’t require insulin to enter the cells and be used as energy. Therefore, switching the body away from glucose metabolism and towards ketone metabolism is very helpful. Glucose doesn’t store up in the blood (because you’re not consuming carbs), and the impaired insulin signaling isn’t as important since ketones can get into the cells without it. Plus, as described before, ketones enhance insulin sensitivity. Especially in someone trying to manage their diabetes with a low carb or keto diet, thus,
KETO//OS providing therapeutic ketone levels to the blood also provides this benefit.
A diabetic could potentially be harmed by taking this product if that person had uncontrolled diabetes and were already in an acute diabetic ketoacidosis crisis. In that situation, no, they would not want to take the product, as it would elevate ketones further. It would be an unlikely scenario, and someone would have to have their condition uncontrolled to the point of potentially entering diabetic ketoacidosis before purchasing or using ketone supplementation. Diabetic patients should only use this product under the care of a physician.