ketones low carbing type 2

[Sula]

I have been to the diabetic clinic today and everything is fine with Hb1Ac at 5.5, but the nurse said I had ketones in my urine and I have to give a second sample for the doctor. I rigorously low carb and I had eaten very little today. My understanding was that in a type 2 who is low carbing, ketones in the urine just means you are burning fat rather than carbs and there is nothing to worry about? I am worried that if the seond sample shows ketones the doctor will try and force me on to medication that I do not want. My doctor is very mainstream and not impressed with my controlling diabetes with as lower carbs as possible and supplements. Can anyone please help me on this, am I risking ketoacidosis? (which I thought was only possible if you were injecting insulin).

 

[sugarless sue]

As you rightly say you are low carbing so ketones will sometimes be present if you are in ketosis. This does not mean you are getting ketoacidosis which is different altogether. As long as the levels of ketones are not too high which would mean you may be losing weight too fast.

Ketoacidosis occurs with high Bg levels not low ones.

No doctor can force you to take medication ! He should be praising you for your obvious good control of YOUR Diabetes not berating you about how you are achieving that control ! :shock:

 

[Sue o2]

Hi Sula

I'm low carbing and watching portion sizes and am losing a bit of weight too, and the last three times I've been to the doctors I've had ketones in my urine too, the doctor said it is because I'm burning fat but just to be on the safe side she has sent the last sample to the hospital to test for a low background infections.

Sue

 

[viviennem]

I too am a low-carber and regularly have ketones in my urine. The easy way to resolve the problem is to up your carb intake a bit - say, to 70g - the day before the test, or on that same day if you give the sample later in the day. Or, to be quite sure, both days.

That should take you straight out of ketosis, won't affect your BGs too much, and won't delay your weight loss too much either. Saves hassle.

I find the way to handle anti-low-carb HCPs is just not to talk about it too much. "Yes, my levels are well-controlled, aren't they? I'm being careful with my carbohydrate intake" usually works.

Viv

 

[Sula]

Thanks for all the advice everyone, I'll up my carbs a little before the next test and hopefully that will be that!

 

[daisy1]

I too am a low-carber and regularly have ketones in my urine. The easy way to resolve the problem is to up your carb intake a bit - say, to 70g - the day before the test, or on that same day if you give the sample later in the day. Or, to be quite sure, both days.

That should take you straight out of ketosis, won't affect your BGs too much, and won't delay your weight loss too much either. Saves hassle.

I find the way to handle anti-low-carb HCPs is just not to talk about it too much. "Yes, my levels are well-controlled, aren't they? I'm being careful with my carbohydrate intake" usually works.

Viv

Hi Viv - that's exactly the information I am going to need soon :idea: as I am now down to less than 50g carbs per day for the first time and don't think my endo would approve as she checks my carbs on the data I give her each visit. She doesn't understand our point of view, and that it works, and checks that I eat enough (matter of opinion) carbs at each meal. I think she has probably not seen this forum (we're outside UK). She has always, up to now, been pleased with my results and she is very encouraging. I have now had to start lying :shock: You say take more carbs on the day before - have you actually tried this out? Is this early enough or should I do a couple more days to be sure? Or don't I need to worry at 50g carbs - I think you are a lot lower. I had already been thinking along these lines too 8) I think it's a pretty poor show that we have to think about doing this :x

 

[viviennem]

Hi Daisy

Do you check your urine for ketones with ketostix or similar? If you're not showing ketones, you can reassure your endo by saying - 'no ketones so I seem to be getting enough carbs - look at my results!'

If you don't already have them, it's worth getting some ketostix and testing. They are readily available at pharmacies over here, or on ebay, and not expensive. For some strange reason I don't show ketones first thing in the morning, but in the afternoon, so check every time for a day or so, just to make sure. Then experiment with your carbs until you don't show any change, and eat that many for a couple of days before you see your endo.

I don't think I'd be showing ketones at 50g of carb, but we're all different. I very seldom show high ketones - I think I've only once been at the dark end of the colour range.

Does your endo ask you how many carbs you're eating? If not, don't tell! It's a pity we have to lie, but it saves trouble when two opposites collide. I tell our practice nurse and my favourite GP what I eat, but not the diabetic specialist - I keep my head down with that one!

If you show your endo your food diary, just add a fictional slice of bread at each meal.

At least, if we're going to burn in hell for lying, we're delaying actually getting there! :lol:

Viv

 

[daisy1]

Hi Viv - thanks for your help. I was hoping you would answer I have never thought of checking for ketones but will do so in future. I've got to find out what they are in French though so I can get some Ketostix or whatever they call them here at my pharmacy. I will feel stupid if I don't know the proper words :lol: Maybe Phoenix could help me here if she sees this I think you live in France don't you? Anybody live in Switzerland? I know neither the word for ketones or the name for ketostix.

My endo has never asked how many carbs I have been eating - just looks to see if I have had some. I never gave her the quantities anyway :wink:

I was planning on adding in some carbs - potatoes or bread - onto my menu lists, to keep her happy. 8) I've got plenty of time to get sorted out as my next appointment is beginning May. I hope she won't wonder why my weight is rattling down so fast whereas last visit it had gone up :shock:
Have a nice day, Viv

 

[cugila]

Daisy.
I may be wrong but I think Ketostix is the trade name wherever you are. However from the package I have in front of me it also describes them in several languages -
French : Bandellettes reactives pour analyse d'urine.

A French online Pharmacy describes them so : Ketostix 50 Bandelettes

Hope that helps.

 

[daisy1]

That's great Ken. Thanks a lot I'll go and get some on Monday.