Can you still get DKA with normal BS but high ketones?

[briony1]

I’ve been poorly today so haven’t eaten or drank enough but didn’t know if high ketones still meant I was at risk of DKA?

 

[sleepster]

Hi @briony1, I wasn't sure so did a google and this came up from this website:
EUGLYCEMIC DIABETIC KETOACIDOSIS
In most cases, ketoacidosis in people with diabetes will be accompanied by high sugar levels. However, ketoacidosis can also occur at low or normal blood glucose levels. This is referred to as euglycemic diabetic ketoacidosis and may occur if someone who is insulin dependent neither eats nor takes sufficient insulin for a prolonged period of time.
(https://www.diabetes.co.uk/diabetes-complications/diabetic-ketoacidosis.html)

How high are your ketones? I personally would give 111 a ring

 

[sleepster]

If your ketones are over 3 get yourself to A&E.
From the NHS:

If you do a blood ketone test:

• lower than 0.6mmol/L is a normal reading
• 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and you should test again in 2 hours
• 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible
• 3mmol/L or above means you have a very high risk of DKA and should get medical help immediately

If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA and you should get medical help immediately.

It's not worth taking the risk.

 

[Marie 2]

Usually your BS/Bg levels being high is a sign of lack of insulin which causes DKA, But it's lack of insulin that causes DKA not actually just having high blood glucose. People can have very high Bg numbers and not have ketones because they still have enough insulin to stop it.

But it's ketones that tell you if you are at risk of DKA. Seek medical help right away if your ketones are too high, it's a risk we always have to be very careful of.