help needed - recurring ketones and insulin resistance

[claridge]

Hi,
I have been diabetic for 4 years and the past year have had a lot of stress from work - l developed a severe rash all over my body (even neck and face), later discovered l had high ketones, stopped exercising due to rash. My ketones keep going high though and l have become insulin resistant and my blood sugar just keeps going high and l have to take so much insulin to get it down. Whenever l exercise to try to become less insulin resistant my ketones go up and my rash gets worse again. I do low carb which l think may be a problem but would rather not change. But the past 3 years l low carbed with no problems at all and really good control, however l didnt have the stress then.
Any advice would be great, l have had the worst coulple of months of my life and dont know what to do.
Thanks
Jo

 

[GlazedDoughnuts]

You said you've adopted a low carb diet, in which case you will be producing ketones...Diet induced ketones.
http://lowcarbdiets.about.com/od/faq/f/ ... etosis.htm

Try a normal balanced diet, i.e. one not devoid of carbohydrates. As long as you take enough Insulin you should not be producing ketones.

A reduced carb diet is good for those who need to lose weight, but if you're of normal weight eat some carbs :thumbup: Exercise, take your Insulin and all will be well.

If you're over weight, see if weight loss removes resistance, otherwise I'm afraid you will either need drugs to increase sensitivity or may be changing Insulin may help...Speak to your GP in any event

 

[claridge]

Thank you for the reply. However l was doing the low carb diet for the past 3 years and not once did l have a problem. Its only the past year with stress etc. Im just really worried about my bs continually going up, l just keep upping my background insulin almost daily as it just goes up and having to take twice the usual amount of Novorapid just to get it down!
And when l exercise the ketones go up and my rash is so so bad - its emotionally so upsetting and depressing. if l introduced some carbs what would you recommend? Also what type of exercises would you recommend? Sorry to ask simple questions but feel l need to go back to basics as some exercises just make my bs go up.

 

[claridge]

Also definitely dont need to lose weight, type 1 and skinny.

 

[GlazedDoughnuts]

How many units of Insulin are you using daily?

If you're stressed out it's quiet normal needing more Insulin, but your description of doubled Insulin suggests that either you've some mega resistance or may be your pancreas was producing *some* Insulin but now has completely stopped hence more Insulin required.

As for carbs, if you want to avoid big spikes try the slower digesting stuff i.e. brown rice, rolled oats & etc. Exercise - take your pick...Choose something you enjoy, building a bit of muscle is never a bad thing as they enjoy using up glucose!

What was your last blood sugar average, and is your healthcare team aware of this rash?

If you haven't already, book an appointment with your GP/Diabetes specialist.

 

[claridge]

ha l have been to see everyone - GP, dermotologist, healthcare team etc but they all see it as eczema= steriod cream as not related at all to the diabetes. I ended up going to a&e last night again to get checked (due to drinking gallons of water l was fine) but he referred me to a diabetic specialist at the hospital so fingers crossed. The rash and itching was so so bad yesterday (from exercise and resultant high ketones) literally its deep red on both sides of my neck and most my face l think l look awful. Only did walks today, plenty of water and have had half a sweet potato, and half a slice of bread as my carbs (havent done in 4 years!) so will see how it goes. Will try the eating small amounts of carbs and injecting. Im just scared to exercise now as l dont want to get high ketones and rash again but hopefully with eating small carbs it might help. I have had huge stress this year so l think its that. My background insulin was abot 22 last year, today its 46! And still going up. Its quite upsetting not being in control of it. What is a 'normal' amount of background insulin?
Last BS average was around 5.5 l think- yes sounds amazing and healthcare team thought so but thats only because my BS goes up and l take more background, also its an average of highs and lows so when you look at the highs and lows l would say not so good.
i went for a massage on sat and my BS actually went down amazing - shame l cant have daily massages to help.
Possibly a change of career and a 6 month holiday would work ha.

 

[donnellysdogs]

What are your actual highest readings and lowest readings running at.

Personally, I dont know you, but I think you have starved your body of carbs.. Introducing 1/2 sweet tatty n 1/2 toast? - makes me wonder what you were previously having as carb intake...however.. Lets move forward.. You need a balanced diet.. Otherwise you will be giving yourself constipation or diaaorhea as well as ketones and rashes...I'm not saying not to low carb, just to give yourself a balance of good food and vitamins, profein, fat and carbs etc...

Are you a driver? 5.5 hba1c and mainlymentioning highs n ketones means that you must be having too many lows too.

It doesnt matter how much insulin you have.. Don't worry at the moment comparing it too last year etc... Just look at and plan to improve todays levels and todays insulin.
Our bodies dont work the same everyday, yet alone every year.. And yes stress and exercise can have impacts on our bodies...

Have you had all your wee specimen checked recently with your hba... Were those tests ok?

Do you test two hours after a meal.. ? Without actually seeing a days blood levels.. It very hard to give any advice on insulin and getting balanced levels...

 

[GlazedDoughnuts]

Excellent advice from the chap/lady above.

I have quadrupled my background Insulin since diagnosis...From 10 units to 40 daily. I wouldn't worry about it too much as long as you're not becoming over weight or still have poor blood sugar control.

There are websites out there offering ratios to work out averages, but as said above we're different, we live different life styles and therefore will have different Insulin needs :thumbup:

The whole concept of low carb is amazing if you're overweight/want to lose fat quickly, but someone who is of normal weight/underweight there isn't a need. Eating a balanced diet and exercising will keep you trim, well energised and allow you to eat whatever you want in moderation.

Also what are your daily blood sugar readings like?

 

[claridge]

I low carbed as its easier to maintain BS levels - well it was ha.
For the past 3 years l have eaten low carb - meat/fish/eggs/veg/salad/nuts/seeds. Basically just no bread pasta pot's rice or high sugar veg, weight unchanged in that time with lots of exercise, never had a problem till this year with the stress.

Blood sugar readings - l have had a few big lows this year, but at the moment lm just getting more highs, highest l guess wou has been about 15 on waking - through the day it keeps going high when l check it ie 10 etc and constantly taking insulin but have started walking and the insulin is more effective in the day but overnight l keep waking and have to take more insulin but because l cant exercise in my sleep l seem to need double the amount.

All wee specimens etc at docs have all come back fine as far as lm aware.
Am a driver but l dont take insulin before l drive.

Xmas day and treated myself to half a bottle or so of champers lovely, but nowl itchy all over and starting to get shaky and l know alcohol is not good if any ketones in system so downing water!

Nutrition wise am so confused now. Carb wise today l had a couple of oat buscuits and 2 half slices of bread - should l be eating more?

I test quite a lot at the moment l would probably say up to 10 times in the day and overnight if l cant sleep l check it.