A few questions and a bit of help

Toofycat

Member
Messages
6
Hi everyone my name is Janine, type 2 diabetic diagnosed in 2004. Diet controlled for a while then different medications tried from about 2012, currently on dapagliflozin and ozempic.
I had my review a few weeks ago and last week the dr rang with results (can’t remember exact numbers) anyway she said about starting insulin and also about protein in urine. Is prescribing for the kidneys but I got a 3 month stay for insulin.
Anyway have been lurking on the low carb forum ever since and started adjusting my diet last week - 6 days in now.
Apart from one reading of 9.7 my numbers have consistently been between 4.5 and 5.5 pre meals and 2 hours post.
But in the last few days I have been feeling meh - headaches, a little nauseous and really low energy.
So after reading more I purchased ketostix this morning and the colour was at the top end - 16mmol/L.
My questions are do I need to be worried about this? And could this be the result of me taking dapagliflozin?
Apologies for the long post.
Edited to add - I’m eating between 60&70gms of carbs every day.
 
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Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
Hi and welcome @Toofycat (love the name!)

With ketones that high, I definitely think you should seek medical advice, whether that is ringing your doc, or ringing 119
However, be prepared to have to explain to them the link between dapagliflozin and ketoacidosis, since they may not have come across it before, even if they are used to treating T1s with Diabetic ketoacidosis.

This is a link showing the difference between diabetic ketoacidosis and nutritional ketosis (and your ketones are much higher than in nutritional ketosis)
https://www.diabetes.co.uk/in-depth/nutritional-ketosis-vs-dka/#:~:text=DKA develops when ketone levels,and death if left untreated.
and these are links showing Dapagliflozin and the risk of ketoacidosis
https://journals.lww.com/md-journal/fulltext/2020/05220/dapagliflozin_associated_euglycemic_diabetic.50.aspx#:~:text=Eu-DKA is an uncommon,<200 mg/dL).
and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023663/
and https://www.diabetes.co.uk/news/201...ncreased-dka-in-type-1-diabetes-98512505.html

Please let us know how you get on?
 

Toofycat

Member
Messages
6
Thank you, appreciate the info. I’ll get in contact with my Dr. Even after seventeen odd years of living with diabetes I still feel like a novice at it. Lol
 

Toofycat

Member
Messages
6
So spoke to the diabetes nurse and she advised to stop the dapagliflozin and to up my intake of water ++ and possibly slightly more carbs. Keep an eye on ketones and get back to them if no change. So feel slightly more at ease and hopefully those ketones will start dropping.
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
That is good.
I hope you start to feel better soon, but take it easy. Ketoacidosis is very hard on the body.
Don’t hesitate to seek further medical advice if things don’t improve.
 
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Toofycat

Member
Messages
6
Thank you, yes I think I may have gone in too hard and fast without realising the effects from the dapagliflozin eek!
 

Andydragon

Well-Known Member
Retired Moderator
Messages
3,324
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Thank you, yes I think I may have gone in too hard and fast without realising the effects from the dapagliflozin eek!
I hope you are feeling better now. I got a letter from the NHS telling me to be careful when I was on it specifically about DKA so assumed it was universally warned to everyone

it has some amazing effects and seems to be seen as a bit of a miracle drug but sometimes the risks aren’t always passed over to us patients :(
 

Toofycat

Member
Messages
6
Feeling better during the day...still headachey in the morning thanks Brunneria.
Andydragon - thanks. No wasn’t warned about the DKA unfortunately.
 
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