Ketones are pervasive in nature. The formation of organic compounds in photosynthesis occurs via the ketone ribulose-1,5-bisphosphate. Many sugars are ketones, known collectively as ketoses. The best known ketose is fructose, which exists as a cyclic hemiketal, which masks the ketone functional group. Fatty acid synthesis proceeds via ketones. Acetoacetate is an intermediate in theKrebs cycle which releases energy from sugars and carbohydrates.[8]
In medicine, acetone, acetoacetate, and beta-hydroxybutyrate are collectively called ketone bodies, generated from carbohydrates, fatty acids, and amino acids in most vertebrates, including humans. Ketone bodies are elevated in the blood (ketosis); after fasting, including a night of sleep; in both blood and urine in starvation; in hypoglycemia, due to causes other than hyperinsulinism; in various inborn errors of metabolism, and intentionally induced via a ketogenic diet, and in ketoacidosis (usually due to diabetes mellitus). Although ketoacidosis is characteristic of decompensated or untreated type 1 diabetes, ketosis or even ketoacidosis can occur in type 2 diabetes in some circumstances as well.