Ketones in blood type 2

[MrsDiabetic]

Hi,

Can you get ketones in blood in type 2 please? Or only in type 1? Can anyone explain this to me please?

What do you think?

 

[ert]

Everyone, including non-diabetics, have ketones in their blood as an end product of fat-burning. It's nutritional ketosis.

 

[HSSS]

Do you mean wanted or unwanted ketones?

Many type 2 deliberately induce a nutritional and beneficial low level of ketones using a ketogenic diet by avoiding glucose spiking carbs, present alongside low glucose levels.

However I suspect you mean high ketones alongside high glucose levels and are referring to diabetic ketoacidosis - a very different situation.

Yes this can happen in type 2 but it’s fairly rare. DKA typically involves high glucose and high ketones in the absence of sufficient insulin. Most type 2 actually produce a great deal of insulin, but can’t use it well. Certain medications can increase the risk a bit (particularly when used alongside a low carb diet).

Personally I believe any type 2 that has a DKA should be checked thoroughly for insulin production, to check they aren’t in fact a LADA (a slow adult onset variation of type 1).

 

[LittleGreyCat]

People often go into mild ketosis overnight.

 

[EllieM]

Hi @MrsDiabetic, I assume this comes to mind because of your own recent DKA? Are you still waiting for your cpeptide and GAD results?

 

[MrsDiabetic]

@EllieM yes and yes still waiting

@HSSS I ment unwanted ketones. I am sorry if I used wrong terminology. I am new to all of these. Never heard of ketogenic diet before, learning something new each day

 

[EllieM]

@EllieM yes and yes still waiting

@HSSS I ment unwanted ketones. I am sorry if I used wrong terminology. I am new to all of these. Never heard of ketogenic diet before, learning something new each day

A ketogenic diet is just low enough carbs to mean that fat is being used as the main energy source, thereby generating ketones. I'm on a moderately low carb diet, and ketones of 0.3 or so are normal for me. (Only time I remember being over 1 I had a stomach bug and had fasted for a day.) I believe dietary ketosis is supposed to start at a blood ketone level of around 1 ??? (Not sure about this, so happy to be corrected by the more knowledgeable.)

If my personal ketones were over 1, I'd be concerned if I had accompanying high blood sugars, as I'm not aiming for a keto diet. (Waits for correction from more knowledgeable T1s),

I believe that pump users can go into DKA quite quickly if their pump stops working, because all their insulin is short acting. I personally have never had a DKA in 52 years of insulin use, but then I've always had injected insulin in my system. (Though my diabetic consultant was a little surprised when I told her this a few years ago, and immediately issued me with a ketone testing meter. Before that I just used urine testing strips for ketones.)

Anyway, I hope you get your results soon.

 

[HSSS]

@HSSS I ment unwanted ketones. I am sorry if I used wrong terminology. I am new to all of these. Never heard of ketogenic diet before, learning something new each day

No need to apologise. It’s a steep learning curve and if you don’t ask you don’t learn.

 

[Fenn]

Hi, I spent a good few years as a T2 (or not) first on tablets, later on insulin and found it weird that the maybe fifteen times I checked my keytones over the years, I always had keytones present, ranging from 1 to 2.8 if I remember correct, It didnt seem to matter what I ate. I got rediagnosed as T1 (or not) and still always have them, I eat lowish carb (or not lol). I have no idea why or if it meant anything at all in retrospect but I always found it odd because I used to read about folks trying to have keytones so they knew they were low enough carb to be keto. I hope you find some answers, best of luck.

 

[becca59]

I had severe Ketosis when pregnant and suffering with hyperemesis. (Pre diabetic days)

 

[ert]

If my personal ketones were over 1, I'd be concerned if I had accompanying high blood sugars, as I'm not aiming for a keto diet. (Waits for correction from more knowledgeable T1s),

The risk is when you have high blood sugars over 13 mmol/l for an extended period of time and are unwell (if you think you are an undiagnosed type 1). If this happens then phone 111. When on insulin you are take extra insulin following sick day rules which clears ketones. I run my ketones between 1 to 4 mmol/l on my low carbohydrate/keto diet. This is nutritional ketosis.

 

[Dark Horse]

This article seems to explain the difference between nutritional ketosis and diabetic ketoacidosis (DKA) quite well:- https://insulinnation.com/living/diabetic-ketoacidosis-vs-nutritional-ketosis/

Regarding DKA, it most commonly occurs in people with type 1 diabetes but it does sometimes occur in people with type 2. For example, some people of African origin have a variant of type 2 called 'Flatbush diabetes' which is more prone to DKA:- https://gpnotebook.com/en-gb/simple...type 2 diabetes,of autoimmune type 1 diabetes

Sometimes there is confusion between DKA and HHS (hyperosmolar hyperglycaemic state):- https://www.diabetes.org.uk/guide-to-diabetes/complications/hyperosmolar_hyperglycaemic_state_hhs

 

[MrsDiabetic]

@Dark Horse thank you that was very informative

 

[Em16]

Hi, I was sent to hospital by my GP when she tested my keytones (as part of demonstrating how to use a glucose meter) and they were at 3. My sugars were 8.1 at the time and I had started feeling unwell a few hours earlier. I was not fully low carb as I had just recently discovered that I was 'pre-diabetic' and, having bought my own glucose meter, I was aware that something was wrong. I was therefore just in the process of learning what a keto diet was about (and know now I would have eaten more carbs that afternoon than I can handle). At the hospital I was monitored regularly for keytones and blood sugars over about 6 - 7 hours. On leaving (with a now confirmed diagnosis of diabetes) I was told to readmit myself if at any point my ketones hit 3 with blood sugars of 13. Hope that helps!

 

[EllieM]

On leaving (with a now confirmed diagnosis of diabetes) I was told to readmit myself if at any point my ketones hit 3 with blood sugars of 13. Hope that helps!

Did you have the LADA diagnosis when you left, or did you have to wait for test results? @MrsDiabetic is still waiting, I believe.