Low Carb VS Ketoacidosis

[Duncan_Scott]

Hi everyone, Ive been type 2 now for some 14 years and managed it pretty well. After a recent spell in hospital from an infection which turned into Ketoacidosis I have tried to go low carb I find this quite straightforward and my sugars have been great and seemed really well controlled AC1 of 6.0 but today I checked my ketones and they have gone from 0.2, 7 days ago to 1.7 today and scared the life out of me. It seems that if I take insulin my weight goes up (not good for sugar control)...if I go low carb to reduce my sugar then my weight my Ketones go up ...the answer from my diabetes consultant was to eat some more carb and take some insulin to bring my ketones down which seems almost self defeating. I take 10 Solostar at night plus 250 metformin, I take 1.2 Saxanta in the morning as well as half a tablet of Jardiance duo...I then use Nova Rapid as and when. Since I have been low carb my usage of Novo Rapid is only about 10 units per day.
The other interesting thing seems to be that the advice for bringinh ketones down is to drink more water to flush it out but because i'm on Jardiance duo this also flushes carbs out which means that my ketones go up ...or does it?
Can anyone help?

 

[Goonergal]

How low carb are you? Could the ketones be due to being in nutritional ketosis? That said, your medications and previous DKA add layers of complexity to this that means you need input from a medic.

 

[Brunneria]

What are your blood glucose levels?
You mention 6, but what are your highs and lows, and do you have any sustained highs?

 

[Roggg]

1.7 is a good level if your diet is low enough to be ketogenic.

 

[Duncan_Scott]

Hi Everyone, thanks for the replies...my sugar levels are running at about average of 5.7 during the night about 7.0 during the morning 6.2 during the afternoon and 7.00 in the evening...I rarely go lower than 5.0 and most of the times after a meal I am around 8 or 9 ... so i think my blood sugars are low/good but my keytones are up...
My daily carb level is around 50g-75g per day on weekdays and a bit higher on weekends.
I have only recently started checking the keytones since starting on the Jardiance duo and I am wondering if this could be as a result of this particular drug.
After being diagnosed and treated as Type 2 for the last 14 years, my diabetic consultant who treated me in hospital is not sure that I am ...just to help me become more confused.
Woke up at 2. am and checked my ketones and I'm reading 1.9 Blood sugar level is 5.4

 

[Brunneria]

Thanks.
I think you will find this link helpful.
It explains the differences between nutritional ketosis and ketoacidosis,
https://www.diabetes.co.uk/in-depth/nutritional-ketosis-vs-dka/
and this link lists raised ketones as a side effect of Jardiance.
https://www.medicalnewstoday.com/articles/326007#side-effects

I would urge you to seek medical advice to ask at what levels your ketones need attention.
Hope that helps!