Advice please, annual diabetic checks and ketones

[zand]

Having struggled with low carbing for the past 21 months, and failing a lot of the time, I finally feel well enough to make a real effort again. I desperately need to lose weight and have reduced my daily carb intake to 25 - 30g. I have my HbA1c etc next week ( it was due in November 2020)

I am concerned that the nurse will be alarmed by ketones. I'm feeling sensitive and wary of people at the moment. How do you deal with an HCP telling you that ketones are bad? I want to be clear and assertive without being rude. Trouble is when I feel down I can come across as being rude just because I am nervous.

It's not been an issue other years as normally when I follow low carb I don't go low enough to produce ketones.

 

[bulkbiker]

Never had them measured at my reviews ever.
Pretty unlikely they will measure yours unless you know something ... ?

 

[zand]

@bulkbiker Well that's good to know. I just feel the need to be prepared for whatever they throw at me because I am not managing to think 'on the spot' nowadays, after falling and having concussion a couple of weeks ago. I was trying to avoid the blood tests until I felt better, but I needed a medication review for a repeat prescription for a BP tablet. Hopefully I can lose enough weight this year so that I don't need a medication review at all next year.

 

[Goonergal]

I recently had a raft of blood tests as I’m having some odd symptoms investigated. The doctor did a urine test and mentioned diabetes so I simply warned her that she would find ketones. When she asked why I said it was because I was eating a ketogenic diet. She didn’t respond and all was well.

Will she definitely test for ketones? And are you already in ketosis? If so and she does a urine test they may not show, or will likely at least be lower than a reading from a ketone blood meter:

If there is a suggestion that ketones are bad, rather than challenging could you ask for some information to take away and read? Would diffuse the situation and I doubt it’d be forthcoming.

 

[zand]

@Goonergal thanks. Asking for info is a great idea.
Don't know if I am in ketosis yet, I will post again when my new ketostix arrive.
And yes, of course the ketones won't be that high in a urine sample, that's something my brain had forgotten in my panic.

 

[Lamont D]

Having struggled with low carbing for the past 21 months, and failing a lot of the time, I finally feel well enough to make a real effort again. I desperately need to lose weight and have reduced my daily carb intake to 25 - 30g. I have my HbA1c etc next week ( it was due in November 2020)

I am concerned that the nurse will be alarmed by ketones. I'm feeling sensitive and wary of people at the moment. How do you deal with an HCP telling you that ketones are bad? I want to be clear and assertive without being rude. Trouble is when I feel down I can come across as being rude just because I am nervous.

It's not been an issue other years as normally when I follow low carb I don't go low enough to produce ketones.

In all my tests and examinations, if I have had my ketones tested or even asked about when informing them I am in ketosis. Even when I had a UTI, never mentioned.
Telling you not to worry is a bit silly, however, I believe I can see you are a bit fearful of actually going to the doctors, never mind the results of the tests. I know that feeling of fear and dread of how people view and judge you.
That is okay.
Regardless of of that, once your back home, it won't be as important, and I went through the same kind of fears when I had my breakdown.
You know what you have to do and I will wish you well in your getting back on that horse. It's not easy and hopefully you will get the support you deserve.

Finally, I have noticed through my journey that arriving is better than traveling and its never as bad as you fear it is. It won't do you harm.

Keep safe, be good, and get your health back, and your life.

 

[Fenn]

Fantastic effort OP, good luck with your blood test.

 

[zand]

Well thanks everyone. My urine wasn't even checked at my appointment as it wasn't the DN .

I needn't have worried anyway as my blood ketones before the appointment were only 1.2

Thanks for the reassurance