Blood ketone meter anyone?

The strips are expensive I find, so I have never bought any. Only time mine were measured was while in hospital for minor surgery. Fasted they were, 2.5 with a BG level of 5.6 on the morning after surgery.

I think @bulkbiker dabbles in this kind of witchcraft, I may be wrong however.

My new Liffesmart bgl meter does ketone measurements as well, as @Tophat1900 said the ketone strips are expensive as they are not on the NDSS subsidy list here in Australia. I will not spend $10.00 for a box of ten strips.

Hi @Roggg

I have a ketone meter - the Caresens Dual (it can also be used for BG). Got the meter for free, but the strips are expensive so I test once a week only - same time, same day for consistency. It really is for curiosity. I do actually have another one, which was offered free with a very large quantity of strips for not very much a while back. That one is the On Call GK Dual. I believe. @bulkbiker uses that one too.

Finally, if you want a cheaper way of checking that you’re in ketosis, try something like this (I also have this!): https://www.amazon.co.uk/Dragon-Honor-Professional-Breathalyzer-Portable/dp/B07GGQK9HL

@Ellie-M can't comment on ketones from a type 1 perspective.

I'm also packing the On Call GK Dual. The strips are like two hundred quid each (or something ).

I rarely use it these days as it's kind of surplus to requirements, but it's a nice tool to have. I have nothing to compare it with but it most certainly works

The one I use is this

https://www.valuemed.co.uk/collecti...n-you-buy-50-on-call-blood-ketone-strips-here

cheapest have ever found in the UK

@Roggg use it to check ketosis although rarely use it these days .. mainly to disprove the "eating too much protein knocks you out of ketosis" belief because where I am at the moment it doesn't.

I bought one of the original Ketonix breathalizers over five years ago - it needs nothing more that a bit of electricty to recharge it occasionally and it uses a "traffic lights" systems for checking ketones via breath acetone levels. They are now well out of my price range! My original intention was to discover a bit more about very low carb and ketosis.

I also have a Libre reader which came as part of the kit with my first sensors and this also works as a basic ketone as well as glucose monitor with appropriate test strips. It's useful sometimes to see all three readings taken at the same time.

Personally I don't believe I get "knocked out of ketosis" but do believe it's perfectly natural to go in and out of ketosis all the time depending on what proportions of carbs and fats are eaten in relation to amount of fuel required and used.

For @EllieM:

ianf0ster said:

Exactly, one can't help but wonder who is being protected here?
I've noticed that the Virta staff always seem to be plugging the idea that a very Low Carb or Keto 'Way Of Eating' should only be undertaken under medical supervision - after all if they can't make a living prescribing more drugs for diabetes, then doctors need to have a role in protecting those who understand the disease better than our GPs do from ourselves!

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I think there's a possibly a lot of scaremongering/fear of of hypos if diabetics don't get their insulin doses correct if they eat very low carb/ketogenic diets. I assume that Bernstein's theory of low numbers comes into effect, but as a diet controlled T2 I'm obviously in a position to stand corrected.

EllieM said:

That is very very interesting, thank you, but note the

People with diabetes should avoid ketogenic diets and follow their doctor’s treatment recommendations to prevent ketoacidosis.

I wouldn't go on a ketogenic diet but do find my levels easier to manage on a slightly lower carb one (maybe 60g per day?) But my dietician wants me to have at least 90g (30 per meal).

Given the amount I test (8 times a day?) high levels get dealt with very quickly. Am not sure why I need to avoid very low carb....

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personal side note: you probably do run some nonzero ketone level when you wake up. test it if you like. don't worry about the number as long as you feel well and the number is somewhere that doesn't scare you.

None of what I'm about to say is backed up by anything resembling evidence. Take it with a nice fat rock of salt.

"People with diabetes should avoid ketogenic diets[...] to prevent ketoacidosis."

The suggestion has never made mechanistic sense to me either. If you want to go VLC, I say you have no reason not to, as long as your blood sugars stay stable and your ketone level stays between a reasonable pair of numbers as determined by intercurrent conditions which could benefit from ketosis, your previous propensity to ketoacidosis, and the sensitivity of your meter.

Surely because a ketogenic diet would reduce to as near to nothing as makes no meaningful difference one of the myriad variables that affect mealtime insulin requirements (that being carbohydrate, which can actually be wrong by 20% either way on the packet and still be legal, at least in the US), it would actually mitigate the likelihood of entering ketoacidosis (or indeed hypoglycemia) because you would never go as high (or as low) if your injection was not enough (or too much) to cover the rest of the meal, so (for highs) you get less paradoxical glucagon release.

Someone mentioned RKB's law of small numbers, and I think that was what I was expressing in the above paragraph.

It would also be useful to harm-reduce diabulimia because they wouldn't need to take as much insulin (an anti-catabolic hormone - people who want to lose weight fundamentally want to be catabolising) to stay euglycemic for a given amount of food, so they'd still maintain a low weight but have less complications than if they ate a typical diet and were actively diabulimic.

Although, I've heard of eugDKA in some type 1 diabetics (possibly this was caused by SGLT2 inhibitors though...) because their blood sugar maybe goes to 6 or 7, while their ketones run into the 10s or 12s, because they're not taking the insulin to cover the ketones (glucose is not the only insulin-dependent blood nutrient! Ketones demand some insulin too). I've also heard of ketotic hypoglycemia, which is where the brain still works fine (not neuroglycopenic) but the blood sugar is objectively too low (say, 2.1 mM/L). Non-neuroglycopenic hypoglycemia is uncharted water in the world of diabetes treatment.

Also a type 1 diabetic friend of mine has been told by his care team that ketones destroy organs. Like how even?! How, mechanistically, could ketones destroy organs? Humans had them any time we didn't eat for more than a few days back when food availability wasn't guaranteed. We'd not be here talking about treating diabetes of either type if ketones destroyed our organs. Why are not people taught to develop a healthy respect for ketones as yet another fuel source requiring precise regulation with insulin (just as glucose requires)?

EllieM said:

Anyone know what the situation is for T1s and dietary ketosis? I am pretty low carb at the moment and seem to run at 0.5 ish, on my meter, but I'm assuming I don't want to run that much higher so that I don't risk DKA???? Mind you, I don't test very often either because of the price of the strips....

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I see no reason to worry as long as you are feeling reasonably healthy, your glucose is inside a good fasting range (since you're not tacking it up with dietary glucose, so don't include the usual postprandial extension), and you're not going above, let's just throw a laywoman's heuristic at it, 4 or 5.

I test for ketones with the on-call meter too - just when fasting or trying to eat very low carb, mainly for motivation. Very expensive so I tend to only test once in the day - I've found mid morning to early afternoon is when my ketones would be highest.

I’m a type 2 and you can still end up in ketoacidosis even if your blood sugars are normal. Just so you know It’s called euglycaemic diabetic ketoacidosis or eudka. I have a ketone monitor and having experienced eudka for the third time last week, I shall test when I’m feeling unwell as this seems to trigger it. I was using strips I paid for as I was following a keto diet, but I had ten free for medical reasons too. It’s a rare thing to happen. It felt good to know you were still in ketosis.

@JacquelineGough it seems that this rare form of DKA is mostly associated with type 1 and the cases involving type 2s relate to those taking blood glucose lowering medication such as SGLT-2 inhibitors. It is not a side effect of a ketogenic diet.

DCUKMod said:

Jacqueline, could you tell us what, if any medication you take, to help you manage your diabetes?

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I was on sglt-2 inhibitors the first time I had it, but not the second and third. I was only on metformin and trulicity. I’ve now been put on insulin after this last episode. My consultant called me weird and another dr said I was a unicorn as I was so rare.

I know it’s not normal to get eudka with a keto diet. I think the keto diet is the way forward. It makes sense to me.