Ketones!!!

[Rebecca.]

I have had ketones in my urine for the last two days, a reading of 0.8.. I managed to get rid of them all together last night but this morning they had returned and are back up to 0.8 again. I have been constantly injecting insulin to try and get rid of them but nothing seems to be happening.

My readings have been 10, 8, 12 and 4 hours ago was 18 so I injected 7 to correct this and now my reading is 17! Surely it should have come down a lot more than that?

 

[robert72]

Drink plenty of water to try and flush them out. Do you think you might have a bug or infection?

 

[Rebecca.]

I've got a water infection, I was pretty poorly on Tuesday and Wednesday being sick, feverish, back pain but that's all cleared up now and I feel fine

 

[robert72]

Maybe just a hangover from that then, but it would be good to get the BG down. Are you eating normally or off your food?

 

[Rebecca.]

That's what I was thinking, but on the ketostix scale I am right on the high end so was a little worried. I haven't been eating a lot the past few days but have regained my appetite today and have had regular meals

 

[robert72]

Possibly starvation ketones then, but it still warrants close attention.

Are you saying it's +++ on the ketostix chart? That's rather high with BGs above 16 - risk of developing DKA if it doesn't improve.

 

[Rebecca.]

Yes been at +++ all day despite doing my correction doses, my BG reading is 12.5 now

 

[robert72]

Good that the BG is going down. Hopefully it will settle down soon if you can flush the ketones out.

 

[Rebecca.]

Hopefully, I will keep a close eye on it. Thanks for your help

 

[Spiker]

Rebecca do you know about Sick Day protocols? When you have high ketones, you have to take extra insulin to reduce the ketones, in addition to normal insulin for carbs, for corrections, and basal. At those ketone levels you would be advised to take an extra insulin dose every 2 hours equal to 20% of your total daily dose (TDD) of insulin. And test every 2 hours.

Contact your DSN and get them to teach you Sick Day rules.

 

[noblehead]

Spikers right, when your unwell and experiencing high bg levels you need to apply the Sick Day Rules, there's a good explanation of them in the following:

http://www.diabetes-support.org.uk/info/?page_id=141

 

[Rebecca.]

Thanks for your replies, I am aware of the sick day rules but not 100% on it so thank you for the link..

The ketones have completely gone this morning and my reading is 6.8 so hopefully there gone for good!

 

[LucySW]

But some ketones can just come with low-carb eating, or not eating much for a bit. It's only ketones in your blood that lead up to DKA. Ketones in urine maybe the starving/low carb kind. But of course until your BG is down below 8-ish, you can't afford to take the risk.

I wd think, perhaps adjust your basal first to get that right to get BG down, then worry (or not) about ketones. I don't think they're such a sacred cow as all that myself.

Good luck anyway

Good

 

[Seriously_Sax1989]

Hey not sure if this is in the link but I was advised that if ketones are above 2.0 then I need to double my correction doses, so if I need to take 2 units to correct, it'll change to 4 units! Hope you keep well x

 

[Rebecca.]

Thank you all for your replies ketones have gone now and bloods are back to normal

 

[fractureman]

Becca is this a **** test of keytones?

 

[fractureman]

When I did my course (you not done) I got a blood meter that tested for keytones as well.
This is much better than urine sample that's old hat now
As others have said just flush through with plenty of fluids.
You've been I'll + had an infection it takes time.
Any human should be drinking 2 litres a day of fluid. In the current temps double that.
Yes means lots of toilet breaks but think fluid fluid fluid.
Keep tabs on BG readings to check your not running too high but 10 or below is fine honest.
Hope this helps

 

[robert72]

I got a free meter from Abbott which also does blood ketones (ask your Dr for ketone strips for this)
https://www.abbottdiabetescare.co.uk/your-products/freestyle-optium-neo/request-meter

 

[noblehead]

The GlucoMen LX Plus is also a meter that does bg and blood ketones, if you ring their customer care-line they will send you one out for free.

 

[LucySW]

The trouble is the strips are fantastically expensive: in the region of £30 for ten.

I looked for these at one point after being given a meter that took them -the Abbott Freestyle Precision - but gave up and concentrated on getting my BS down.