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Help! Advice on LCHF and ketones

CEM2

CEM2

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
hi everyone,

I am type 2. Been diagnosed 2 years. My blood sugar has been pretty out of control. I am morbidly obese, I hadn't been watching my carbs at all.

On Friday my metformin was put up from 750g twice a day to 1g twice a day. On the same day (last Friday) I switched from an out of control diet to totally LCHF. Eating less than 20g carbs a day. Today I've had just 1g carbs. Been eating meat, eggs and salad. My BM is now between 5 and 6.9

I am feeling pretty grim, diarrhoea, nausea, feel achy and also very tired.

I assume this is due to such a sever change in diet. As I am also on dapagliflozin I decided to check my keytones (urine stick) just to make sure it wasn't keytosis.

But I do have keytones in my urine. Between 1.5 and 3 on the dip stick.

From what I have read this is due to LCHF diet and not keytosis associated with DKA. Am I correct? Since Friday my blood sugars have never been so low! Between 5 and 6.9 NO highs.
 
Hi there @CEM2

Welcome to the forum!

For the rest of the world, CEM2 is my sister!
 
Ketones are fine so long as you are not on Insulin. ketones in the self are not a problem but when high ketones are present with raised blood glucose, the Ketone levels can get dangerously high and T1 diabetics can get Ketoacidosis which can be life threatening.

Going cold turkey on carbs has obviously done amazing things for your blood glucose (good) but for this to be sustainable and healthy you need some veggies to take your carbs up to about 20g a day, and increase the nutrients you are getting. I see you are eating salad, so your carbs won't be 1g. Have salad with your lunch, add a tomato and half an avocado. Add green veg to your dinner, have any sort of above ground green veg, cabbage, cauliflower, broccoli, spinach, Swiss chard etc etc. that will probably take your carbs to about 20. When your blood sugar is stable and you are ready to vary your diet more, whenever you eat a new more carby food, check your BG 1 hr and 2hrs after and anything that spikes you too much, eliminate.
Add some salt to your diet, drinking a cup of oxo or similar twice a day will help with the nausea / low carb flu, and make sure you drink plenty of clear fluids. The diet is a natural diuretic so you will lose more salt and water in your pee, until you are fully adjusted to it. In the medium to long term, your medication is likely to need to be lowered.

Good luck.
 
AtkinsMo said:
Ketones are fine so long as you are not on Insulin. ketones in the self are not a problem but when high ketones are present with raised blood glucose, the Ketone levels can get dangerously high and T1 diabetics can get Ketoacidosis which can be life threatening.

Going cold turkey on carbs has obviously done amazing things for your blood glucose (good) but for this to be sustainable and healthy you need some veggies to take your carbs up to about 20g a day, and increase the nutrients you are getting. I see you are eating salad, so your carbs won't be 1g. Have salad with your lunch, add a tomato and half an avocado. Add green veg to your dinner, have any sort of above ground green veg, cabbage, cauliflower, broccoli, spinach, Swiss chard etc etc. that will probably take your carbs to about 20. When your blood sugar is stable and you are ready to vary your diet more, whenever you eat a new more carby food, check your BG 1 hr and 2hrs after and anything that spikes you too much, eliminate.
Add some salt to your diet, drinking a cup of oxo or similar twice a day will help with the nausea / low carb flu, and make sure you drink plenty of clear fluids. The diet is a natural diuretic so you will lose more salt and water in your pee, until you are fully adjusted to it. In the medium to long term, your medication is likely to need to be lowered.

Good luck.
Click to expand...


All excellent advice
 
Part of the problem is I almost went into a DKA and my diabetic team got in a panic over me, which is a different story, but thanks @AtkinsMo that helps (me) a lot!
 
Hi @CEM2, to have ketones when low carbing i perfectly normal. Being on dapagliflozin might complicate things though, as it has happened that kind of mediation can cause ketoacidosis while BG is still normal. Can you test blood ketones?
 
Thank you all so much.

@AtkinsMo i have been using the carbs and cal app to measure g of carbs. Prob not eating enough veg as you suggested. Just having 1/2 my plate as salad but sounds like there is a carb count in salad so that will help too.

@Totto thank you. That is my concern. I am watching it carefully and if I get any other symptoms inc. vomiting then I will get it checked out. My monitor doesn't test blood keytones which is a pain.

Half want to get off dapagliflozin and half don't as I understand it can aid weight loss? ... So so much to loose so need all the help I can get.

@JJO is my little brother and such an inspiration - Losing many stones on LCHF ❤️

Thanks you all
 
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