We would like to emphasize that ketosis is a completely physiological mechanism and it was the biochemist Hans Krebs who
first referred to physiological ketosis to differentiate it from the pathological keto acidosis seen in type 1 diabetes.8 In physiological ketosis (which occurs during very - low - calorie ketogenic diets), ketonemia reaches maximum
levels of 7/8 mmol / l (it does not go
higher precisely because the CNS efficiently uses these molecules for energy in place
of glucose) and with no change in pH, whereas in uncontrolled diabetic ketoacidosis it can exceed 20 mmol / l with a concomitant lowering
of blood pH9, 10 (Table 1).