Sort of. Different people will go into nutritional ketosis at different carb levels. Some people will be able to have 50 g of carbs and still be in ketosis and others not. The keto forums recommend staying at or below 20g of carbs to ensure you are there, but this advice is somewhat conflicted. If you have a ketone meter you can check what your personal carb level is. With that being said, there is no officially recognized “Keto” vs “LCHF”, outside of individual studies which each make their own definitions, so I personally think keto is a subset of LCHF.
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Bingo. @Chris hit the nail on the head.
As well as no magic number for what is considered “keto”, there also is no agreement on what ketone level constitutes “being in ketosis”. The threshold of 0.5 mmol/L is old school - many individuals are well into ketosis with levels of 0.1-0.2. And on the other end of the spectrum, a ketone level of 6.0 or 7.0 is not a red flag “I’m in DKA” warning either.
As always, much of what was written in the past 10 years is either incorrect or just plain no longer accepted. And, take everything you read with a large grain of salt.
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When I was eating low-carb (not keto specifically), I sometimes tested out of curiosity and rarely ever saw anything above 0.4 mmol/L, except after exercise when it would be perhaps 0.8 or maybe even 1.1 mmol/L. But on the flip side, I felt ultra sick with a jketone level of 2.1 mmol/L and blood sugar of 20 mmol/L when a site failed…I can’t imagine a ketone level of 10 mmol/L not being DKA territory in that type of situation. I almost always get a ketone level of 0.1 or 0.2 mmol/L even when eating hundreds of carbohydrates a day. I think what level is “safe” is highly dependent on surrounding factors.
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I can’t understand what you mean about “being in ketosis” at a level of 0.1 to 0.2. I mean there’s always perhaps going to be some level of ketosis going on, but your meter can’t even go lower than that.
and if you measure no noticeable increase in ketone generation above baseline at 0.1, what does it mean to be in ketosis???
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@TiaG I think a great comparison to that question is What do you consider a low / high BG level?
Ketones are produced when the body metabolizes fatty acids (or ethanol). Without writing a book, yes you are correct that virtually everyone (T1’s and non-diabetics alike) produce minute quantities of ketone bodies when they fast. Virtually everyone fasts - every night when we sleep we’re fasting.
Hence measuring low levels (0.1-0.2) might not seem that there’s ketosis occurring, but there actually is. Many people who’s bodies are optimized for ketone production become very efficient at utilizing their ketones, hence their ketone levels are less than 0.5 mmol/L while they’re still completely dependant on non-carbohydrate substrate to fuel their bodies.
How would you verify that they’re in ketosis then? Just because they are not eating carbs so that means they must be using ketones?
I supposed if I were a doctor, medical tech or researcher, I’d stick them on a treadmill in fasted state and run them for 90 minutes or so, then recheck their serum ketones.
Personally I don’t really care one way or another if someone is or isn’t in a certain state (be it ketonic, or blood sugars that are in or out of range). Each of us have our comfort levels. If a long term carb abstainer only shows 0.2 mmol/L of ketones in the morning, that might be perfectly normal for their metabolism. For me my ketones are usually above 0.5 and more often > 1.0.
Just as my sugars generally run around 83 mg/dl (4.6) and never exceed 165. I’m comfortable with these ranges - others may have totally different ranges and comfort levels. 
As the saying goes, YDMV
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Jen - Assuming you were in ketosis, allowing your BG to get to 20 is / was a sure recipe for disaster. Ketosis for T1’s is something you don’t contemplate unless your sugars are in good control. I know sites go bad, but you had a Dexcom with high alerts so I can’t imagine how you’d get to 20 (360 mg/dl).
As far as the feeling ultra sick, I can imagine why. And at the same time I suspect you weren’t taking a ton of extra salt or electrolytes each day to bring your electrolytes back into balance. It’s a good thing you didn’t go into DKA.
YDMV
A couple hours with no insulin is enough to send me to 20 mmol/L, which is what happened in this case. I’d done a correction when I saw I was rising (and I was at a funeral, so didn’t immediately think of the set versus something like emotions), but the correction didn’t work. Within about two hours of the rise I’d put in a new set, so it wasn’t like I wasn’t monitoring. Unfortunately, this happens randomly with some sites, even though I do use metal sets. My body just reacts to them, they stop working completely, my blood sugar starts rising rapidly, corrections don’t work, and within a couple hours I’ll have ketones. I have gotten better at figuring out when this is happening, and now I’m pretty fast to change a set or use a pen to correct if I see an unexpected rapid rise.
I’ve never aimed specifically for ketosis when I eat low-carb, and have never eaten less than 30-50 grams a day, so am not sure I’ve ever been low enough to aim for that. I just eat low-carb to help avoid after-meal spikes. These days it tends to be more like 80-100 grams of carbs, because that’s actually where I seem to be able to get the best control.
I never “allow” my blood sugar to get to 20 mmol/L, but sometimes it happens even when I’m actively trying to prevent it.
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. I know sites go bad, but you had a Dexcom with high alerts so I can’t imagine how you’d get to 20 (360 mg/dl).
I think a lot of times we say YDMV but don’t really internalize the full scale of what “MV” means. I hope it’s not rude to speak for @Jen but my impression, from reading about her experiences, is that she has lots of challenges keeping her numbers in range that many people do not. Such as wonky immune responses to sets that make her much more prone to unexplained or surprise high and low blood sugars. In any case, she seems to be incredibly vigilant and takes much more effort than many of us do, and is achieving really good control.
@Jim_YYC I also think there is, as you say, a lot of speculation out there about what’s dangerous and what’s not about DKA. Is it the ketones themselves, is it the hyperglycemia, is it the electrolyte imbalance, or is there some complicated interplay that we haven’t figured out yet? The truth is we don’t really know for sure. So we don’t know, and can’t say, that for @Jen, it wasn’t the ketones themselves that made her feel sick. I know the only time my son had “high” ketones (at 3.1 mmol/L), he had his pump disconnected all night by accident. And yet because he was at altitude and had done lots of snow play the night before, he was at a perfect 100 mg/DL almost all night and when he awoke. Yet he still complained of feeling sick to his stomach the next day. To me, that’s an indication that the ketones themselves were making him sick. But who knows.
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Apologies @Jen - I took your low-carb and ketones comments to mean you were actively pursuing ketosis. Sounds like that what never the case and it was simply a matter of bad timing (bad site while attending funeral).
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Hello Everyone! I just found you and must say this is my first experience ever joining an online discussion. Thank you for having this available. I was diagnosed with LADA almost 3 years ago… thought I was going through menopause until I was thrown in the hospital with an A1c of 15.
I exercise regularly and do my best to eat very few carbs. Throughout my life I have explored many different ways of eating. Since I can be quite disciplined I found myself getting caught up in the specifics of the diets and wouldn’t listen to my body. Since the LADA diagnosis I have done my best to let go of the names of eating styles and just do Me. I eat a lot of nuts, vegetables, avocados, all meats, eggs, cheese. I have found I can eat a few berries (I use to have some in the morning but the afternoon is better.) I have trouble with other fruit. I can eat some black beans and there is a “low carb” tortilla that I can handle. So I can’t say I specifically follow a Keto diet or any other, I’m just trying my best to monitor my BG, sink into my body and be aware of the signs it’s trying to give me. Some days are better than others and always progress is much more realistic than perfection.
Cheers
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Hi @SFLADA! Welcome to FUDiabetes!
Welcome @SFLADA, thank you for posting, and I hope you enjoy our community. We are a varied bunch.
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I have been using variations of LCHF and trialling different amounts of carbs this year… I seem to have a threshold of around 50g carbs a day that I need to stay below to remain in my ideal place for both exercise and daily life; I’ve been having 60-80 over the last few weeks and that hasn’t worked out quite as well so I’m going to drop the amount back down. I’m currently doing about 12 hours of exercise a week, mixing moderate and vigorous intensity, mainly mountain biking, but I also run (only 2-5 mile hill runs), hike and do weights each week. From an exercise perspective, it has increased my performance and I tend to have more energy, especially during long sessions and full days on the bike. I feel a lot better at the higher intensity stuff too, so a full day of uplifts and downhilling is a lot easier, I tend to recover well between runs. It’s worth noting if I really need to push myself, I occasionally add some carbs during exercise (not recovery), usually about 20-50g over a day and that seems to help my performance and keep up with some of my ridiculously fit friends.
Generally speaking, on low carb, I recover quicker after exercise, have less aches and pains, perform better and in comparison to high carb, don’t really need to worry about my BG crashing during or after exercise, it feels liberating to just get out on the bike for the day and not worrying about stuffing loads of carbs in.
All the above is generally speaking and its not always perfect by a long shot, I still need to put a lot more work (and discipline) into it to nail down all the personal nuances of LCHF for me. It does also appear that I need to be pretty consistent, when I start upping carbs things get a lot more tricky. Other plus points, my inflammatory bowel disease is now a huge amount better… FODMAP made it a lot more tolerable and low carb has actually meant I can now have weeks that are symptom free, I think it’s also helped mentally too, but it’s not the only thing I’ve done so hard to say definitely! Still early days, I think it will take a while to fully get to grips with it all.
Oh, and the food is ace too 
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I would also like to aim for about 50 g a day, because for reasons unclear to me, BG management,bolus, seems better.
How do you manage to stay around 50 g a day? A pear, banana or an apple would be approximately 35-40 g of carbs. LCHF or keto or any type of restricted carb way of eating would lead to little to having a very limited amount fruit, except for perhaps a few berries. I wonder whether carbs from say carrots are “better” than from bread/pasta etc from an allergy perspective? People have gluten/wheat sensitivities, but I have not heard of allergies to carrots, or most fruits. I am under the impression that there are more allergies/sensitivities to grains than to vegetables and fruits.
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