Are ketones always present normal?

[Fenn]

Hi

I detest starting threads for some reason but can't seem to get the answer I need so I apologise

I test ketones occasionally with Libre blood test strip thingies and they range from 2.5 to 0.1 but are always present, no matter if I eat low or high carb food, time of day, insulin injected, always there.

I am currently preferring high numbers during the day than worrying about hypos so only injecting my bedtime long acting and evening meal novo, nothing during working hours but always have the ketones, is this normal please clever people?

Thanks.


Just found out there is no Y in ketones sorry can't change the title

 

[LooperCat]

What sort of BG levels are you running? Ketones are a problem if they’re high.

 

[Fenn]

Fine at night although I do drop to 4 at 3am for some weird reason but don't hypo, during the day it depends what I eat but from 7.0 to 18 lol better than hypo though when I'm working, it does drop however when I eat my dinner and bang in some magic juice.

I'm lucky not to feel terrible (or anything) when high.


Edit: I get some crazy dawn phenomenon thats why its high all day not because I'm stuffing my face with cakes.

 

[Fenn]

I have the long lasting going on during the day so don't see how I can have too little insulin.

 

[Fenn]

So if they don't go high, it doesn't matter? no problem if always there?

 

[LooperCat]

BG in the teens plus ketones is a dangerous thing, just as dangerous as a hypo, if not more so, as a hypo is quickly and easily treated. You really need to discuss this with your care team, as you’re potentially damaging yourself by not taking your fast acting insulin in the daytime.

 

[Tophat1900]

So if they don't go high, it doesn't matter? no problem if always there?

If you're running at 18 and have high ketones then that's cause for serious concern. I'm not sure why you'd be happy running high for long periods of time. Do you have a fear of hypos?

 

[MeiChanski]

I have the long lasting going on during the day so don't see how I can have too little insulin.

Long acting insulin isn’t designed to correct high numbers. It’s more or less to keep you stable when there’s no food around or you decide to not eat. Unfortunately it doesn’t last depending on what basal you are taking. However too much long acting can cause hypos.
Ketones happen when your numbers are high for a prolonged period of time and not enough insulin to bring your numbers down. In the long run, running high isn’t good so you need some insulin to bring it down. Eating something small like cheese or have some peanut better or cream and coffee to halt your dawn phenomenon.

 

[Fenn]

BG in the teens plus ketones is a dangerous thing, just as dangerous as a hypo, if not more so, as a hypo is quickly and easily treated. You really need to discuss this with your care team, as you’re potentially damaging yourself by not taking your fast acting insulin in the daytime.

Thankyou, I am type 2 so don't think its as bad as Type 1's not taking it, I will give it some thought but really would prefer to not take during the day

 

[MeiChanski]

Thankyou, I am type 2 so don't think its as bad as Type 1's not taking it, I will give it some thought but really would prefer to not take during the day

It might not be as bad as type 1, but you and I know that high numbers does add fuel to future complications. If you could contact your team to discuss it, it’ll be helpful towards your management. Because you don’t have to run high, you can run between 6-9mmol/l and still feel okay and happy.

 

[Fenn]

If you're running at 18 and have high ketones then that's cause for serious concern. I'm not sure why you'd be happy running high for long periods of time. Do you have a fear of hypos?

Thankyou, keytones are not high, just there, they don't go above 2.5 and often in the 1's I don't think but have to admit I don't test regular as they are £30 for 10 lol, just curious why they are always there at low safe levels but there all the same.

Do I fear hypos? hehe seriously? yes! but doesn't everyone?

 

[LooperCat]

Thankyou, I am type 2 so don't think its as bad as Type 1's not taking it, I will give it some thought but really would prefer to not take during the day

Sorry to repeat myself, but BG levels in the teens and ketones is very dangerous, regardless of your type. You still run the risk of DKA, and if you’re running levels this high you can guarantee complications. Are you frightened of hypos?

 

[Fenn]

Long acting insulin isn’t designed to correct high numbers. It’s more or less to keep you stable when there’s no food around or you decide to not eat. Unfortunately it doesn’t last depending on what basal you are taking. However too much long acting can cause hypos.
Ketones happen when your numbers are high for a prolonged period of time and not enough insulin to bring your numbers down. In the long run, running high isn’t good so you need some insulin to bring it down. Eating something small like cheese or have some peanut better or cream and coffee to halt your dawn phenomenon.

Thankyou, I think I have an overacting liver or something but having asked if thats possible, no one seemed to understand what I was talking about hehe so I don't think thats a thing, My liver seems to be very energetic in the morning, by the time I've made it from the bed to the kitchen, its too late, my numbers are not consistently high because I inject when I get home, just during the day they tend to climb. Think my bedtime Humalin I lasts for 27 hours and I take it pretty much on the dot of 24 hours.

 

[Fenn]

Sorry to repeat myself, but BG levels in the teens and ketones is very dangerous, regardless of your type. You still run the risk of DKA, and if you’re running levels this high you can guarantee complications. Are you frightened of hypos?

Thankyou, Im confused, aren't we all frightened of them? I mean isn't the fight we all fight one against them? my DSN told me not to worry unless they went over 2.5, we are currently on a break but she did nothing wrong. my numbers aren't high consistently, they are great during the night/evening, what puzzled me was the ketones as I have read people trying to get into ketosis and struggling below say 30g carbs a day so wondered if it was weird that I'm always in ketosis. sorry if I'm not explaining myself very well.

 

[Antje77]

Thankyou, Im confused, aren't we all frightened of them? I mean isn't the fight we all fight one against them?

I fear high bg way more than hypo's. Hypo's are an annoyance but can be dealt with (and in my case usually prevented as I use FreeStyle Libre), high bg may change my life in ways I don't really want to contemplate.
I can understand how having a history of severe hypo's would make a difference but I'd never choose to be in the teens if I can prevent that.
Hope you'll find a solution that will lower your bg during the day and still makes you feel safe!

 

[MeiChanski]

Thankyou, I think I have an overacting liver or something but having asked if thats possible, no one seemed to understand what I was talking about hehe so I don't think thats a thing, My liver seems to be very energetic in the morning, by the time I've made it from the bed to the kitchen, its too late, my numbers are not consistently high because I inject when I get home, just during the day they tend to climb. Think my bedtime Humalin I lasts for 27 hours and I take it pretty much on the dot of 24 hours.

Thankyou, Im confused, aren't we all frightened of them? I mean isn't the fight we all fight one against them? my DSN told me not to worry unless they went over 2.5, we are currently on a break but she did nothing wrong. my numbers aren't high consistently, they are great during the night/evening, what puzzled me was the ketones as I have read people trying to get into ketosis and struggling below say 30g carbs a day so wondered if it was weird that I'm always in ketosis. sorry if I'm not explaining myself very well.

Ketones and Ketosis are both different. As for DP, you can have feet on the floor, where as soon as your feet get out of bed, your BG starts climbing or it climbs during the early hours of the morning. @Mel dCP has linked an interesting article https://www.believethehypo.com/post...-on-the-floor-syndrome-the-inconvenient-truth
Unfortunately we are suppose to correct high numbers so some of us don't wait until the end of the day to do it. Anything above double figures is classified as mild, moderately or extremely high. One reading of 17mmol/l can show ketones or if you're consistently above 14mmol/l, it'll show ketones. I'm afraid something must be done about your high numbers, but that power is in your hands.

I am frightened of hypos because of my lack of awareness, it is also because I have had a few accidents where I didn't wake up and needed an ambulance. However, with the help from my team and support of the Type 1 squad here, I have been able to minimise my hypos so I've been feeling the best that I could ever feel. I have had my insulin changed and I have been prescribed the libre sensor to manage it further.

 

[Fenn]

I get it, ok thank you, sorry, I feel stupid, can this be deleted?

 

[Tophat1900]

Thankyou, keytones are not high, just there, they don't go above 2.5 and often in the 1's I don't think but have to admit I don't test regular as they are £30 for 10 lol, just curious why they are always there at low safe levels but there all the same.

Do I fear hypos? hehe seriously? yes! but doesn't everyone?

I don't like hypos more then the next person, but some people seem to have a much greater fear or level of anxiety when it comes to hypos. How you have presented the issue just comes across to me as being exactly that?

@Mel dCP is right, you should probably discuss your bg control with your care team or hcp or whoever you deal with about getting those levels more stable. If you persist down this path you will be heading towards complications. You can't expect a long lasting insulin to do the job of a fast acting one at meal times. These issues are worth taking up with your hcp for your own good. Just getting those highs down would be a big improvement for you. Maybe discuss your fear of hypos as well if that is a problem.

 

[Tophat1900]

I get it, ok thank you, sorry, I feel stupid, can this be deleted?

Not stupid at all.... you did the right thing in asking.

 

[MeiChanski]

I get it, ok thank you, sorry, I feel stupid, can this be deleted?

You shouldn't feel stupid, I hope you get the help you need. I promise you feel just as good being in the 6-9mmol/l range, compared to 10-25mmol++.