Ketones

[SilverK]

Hello,
I have a question I’m hoping someone can help with?

I’m reducing my carbs and my sugar levels are starting to drop (thank you for that! ). I’m doing it gradually so I’m still eating way more carbs than most people here. (Yesterday 72g total).
My question is this.
If I drop my carb levels low enough to put me into ketosis, isn’t that - producing keytones, a bad thing??

Sorry if I’ve misunderstood something somewhere!

 

[DCUKMod]

Hello,
I have a question I’m hoping someone can help with?

I’m reducing my carbs and my sugar levels are starting to drop (thank you for that! ). I’m doing it gradually so I’m still eating way more carbs than most people here. (Yesterday 72g total).
My question is this.
If I drop my carb levels low enough to put me into ketosis, isn’t that - producing keytones, a bad thing??

Sorry if I’ve misunderstood something somewhere!

Provided your blood sugars are lower (i.e, under, as 12), the ketones are not usually an issue for T2s.

An important exception relates to medications in the class of SGLT2s. Examples of meds in that class usually end in "flozin", such as Dapagliflozin or Empagliflozin.

If you are taking those medications 9with or without any others), then special care is required - Please read the following link.

There's absolutely nothing wrong with taking reductions at a steady pace, so don't feel pressure to go all ninja with your diet straight away.

 

[catinahat]

This should help https://www.diabetes.co.uk/diabetes-and-ketones.html

 

[Jaylee]

Hello,
I have a question I’m hoping someone can help with?

I’m reducing my carbs and my sugar levels are starting to drop (thank you for that! ). I’m doing it gradually so I’m still eating way more carbs than most people here. (Yesterday 72g total).
My question is this.
If I drop my carb levels low enough to put me into ketosis, isn’t that - producing keytones, a bad thing??

Sorry if I’ve misunderstood something somewhere!

Hi,

That would be a case of "nutritional ketosis" on a low carb or keto diet. If your BGs are in normal range.

If however the BGs are high? Regardless of diet.. Then that is a more potentially serous matter.
https://www.nhs.uk/conditions/diabetic-ketoacidosis/

 

[bulkbiker]

Hello,
I have a question I’m hoping someone can help with?

I’m reducing my carbs and my sugar levels are starting to drop (thank you for that! ). I’m doing it gradually so I’m still eating way more carbs than most people here. (Yesterday 72g total).
My question is this.
If I drop my carb levels low enough to put me into ketosis, isn’t that - producing keytones, a bad thing??

Sorry if I’ve misunderstood something somewhere!

Nope... for a T2 ketosis is amazingly good for you.

 

[SilverK]

In hospital a couple of weeks ago my keytones were 3.1 and I was borderline for Keto acidosis.
Not sure inviting keytones in, so to speak, is a good idea right now .
More reading required!

 

[Jaylee]

In hospital a couple of weeks ago my keytones were 3.1 and I was borderline for Keto acidosis.
Not sure inviting keytones in, so to speak, is a good idea right now .
More reading required!

Hi,

Do you have your own BG meter, to gauge how your diet is working day to day?

 

[SilverK]

Yes, they gave me one two weeks ago and they phone every couple of days to check my readings and adjust my insulin.

 

[bulkbiker]

In hospital a couple of weeks ago my keytones were 3.1 and I was borderline for Keto acidosis.
Not sure inviting keytones in, so to speak, is a good idea right now .
More reading required!

What was your blood sugar?
High blood sugar with ketones might not be great..

 

[LittleGreyCat]

In hospital a couple of weeks ago my keytones were 3.1 and I was borderline for Keto acidosis.
Not sure inviting keytones in, so to speak, is a good idea right now .
More reading required!

Much confusion over ketones.
If you are not on medication which carries the risk of a hypo (which implies that if you don't take it you may go hyper) then quite high ketone levels are safe.

For example 3.1 is on the border between nutritional ketosis and fasting ketosis.
Quite normal for people on a low carbohydrate lifestyle.
Values of 10+ are considered to be risky.
Wish I could find an easy link to that Volek & Phinney diagram!

However if you are on insulin or other glucose lowering medication (that is, most stuff apart from Metformin) then your risk is much higher because being hyper with significant ketones risks DKA.

Noting from your previous posts that you seem to be on insulin at the moment, that does make ketones of 3+ a risk area.

It is probably quite risky to start learning about controlling diabetes by going low carb AND taking insulin.
Low carbohydrate eating is usually for newly diagnosed T2s currently on little or no medication, or experienced T1/T2 on more "aggressive" medication up to and including insulin.

 

[ert]

In hospital a couple of weeks ago my keytones were 3.1 and I was borderline for Keto acidosis.
Not sure inviting keytones in, so to speak, is a good idea right now .
More reading required!

I'm sorry you've had a bad experience, which ended up at the hospital. Were you seen by a diabetes nurse or specialist?

It's just that my ketones are 3 mmol/l every day and it is nutritional ketosis, as I fast until 3 pm. I always have background insulin and my blood sugars are in the normal range, so this is simply fat burning.

On DAFNE we learnt that DKA occurs when your blood pH changes as your ketones quickly spiral up to 25+ mmol/l. It occurs when blood sugars above 13 mmol/l for an extended period of time, and you haven't taken insulin (or are not producing enough insulin, or on SGLT2s) or just from illness.

 

[SMS1]

Provided your blood sugars are lower (i.e, under, as 12), the ketones are not usually an issue for T2s.

An important exception relates to medications in the class of SGLT2s. Examples of meds in that class usually end in "flozin", such as Dapagliflozin or Empagliflozin.

If you are taking those medications 9with or without any others), then special care is required - Please read the following link.

There's absolutely nothing wrong with taking reductions at a steady pace, so don't feel pressure to go all ninja with your diet straight away.

@DCUKMod sorry, which following link? perhaps, I didn't see the link you mentioned. I'm taking a 'flozin

 

[DCUKMod]

@DCUKMod sorry, which following link? perhaps, I didn't see the link you mentioned. I'm taking a 'flozin

Apologies, I was going to post this one. @catinahat 's link is very good too thugh.

https://bnf.nice.org.uk/drug/dapagliflozin.html

 

[SMS1]

Apologies, I was going to post this one. @catinahat 's link is very good too thugh.

https://bnf.nice.org.uk/drug/dapagliflozin.html

Thanks, just a note; this link can only been see by people in the UK, Crown dependencies and British overseas territories

 

[SilverK]

Had a call from the Diabetes nurse at the hospital yesterday. She said that my keytones were the bad ones and she wouldn’t recommend doing anything that might put me in ketosis at the moment as it might trigger something else. She said I should wait to speak to the dietician. Hopefully in the next couple of days.

 

[MarkMunday]

Had a call from the Diabetes nurse at the hospital yesterday. She said that my keytones were the bad ones and she wouldn’t recommend doing anything that might put me in ketosis at the moment as it might trigger something else. She said I should wait to speak to the dietician. Hopefully in the next couple of days.

All this scaremongering about ketones is really annoying. Ketones are simply a byproduct of fat metabolism. Even non-diabetics make them. Ketones are only a problem when they are caused by lack of insulin, blood glucose goes up at the same time. DKA starts when ketones go over 10. The blood becomes acidic, and you don't feel so good. As long as you don't skip insulin doses, you have nothing to worry about.

 

[Jaylee]

Had a call from the Diabetes nurse at the hospital yesterday. She said that my keytones were the bad ones and she wouldn’t recommend doing anything that might put me in ketosis at the moment as it might trigger something else. She said I should wait to speak to the dietician. Hopefully in the next couple of days.

How high are your BG levels running?

 

[SilverK]

I went into hospital with a heart attack. My blood sugar was 26. Bit of a surprise. I had glucose going in one arm and insulin in the other for three days. Two weeks after discharge the levels are bouncing around all over the place between 19 and 10. My insulin is being adjusted every two or three days. But there doesn’t seem to be any logic to it. - I ate the same breakfast yesterday and today. Yesterday yesterday it dropped 4 points over the course of the morning but today it rose by 0.5. I don’t get it.

 

[Jaylee]

I went into hospital with a heart attack. My blood sugar was 26. Bit of a surprise. I had glucose going in one arm and insulin in the other for three days. Two weeks after discharge the levels are bouncing around all over the place between 19 and 10. My insulin is being adjusted every two or three days. But there doesn’t seem to be any logic to it. - I ate the same breakfast yesterday and today. Yesterday yesterday it dropped 4 points over the course of the morning but today it rose by 0.5. I don’t get it.

Wow, sorry to read that.

But thanks for clarifying.

What insulin are you currently prescribed?

 

[SilverK]

Lantus, 14 units twice a day and 12 units novorapid 3 times a day before meals. At the moment that’s a fixed dose.