Help arrghhh

[Dudette1]

Hi guys,
Not really sure where to start as I’m just feeling really down today I had my 3 month diabetic check and my hba1c has gone from 42-57 so I decided to start a low carb diet on Saturday, today I went to see the nurse so she could check my urine and I now have 2 ketones in my urine, I have never had them before. She sent me into a panic as she was saying maybe I am type 1 but my blood sugar levels are 5.8 on waking and 6.5 after food. These readings are since I started the low carb diet. So now I have been told because of ketones in my urine it’s bad for me, but if I eat carbs they are bad for me. I can’t stop crying I just don’t know what I’m supposed to be doing! I just feel like I still don’t have an answer, I’m going to see the doctor next week so she can check my urine again, I feel fine, my blood sugar before I started the low carb diet was around 7-11 not managed great and I’m sure no where near what it would be if I was type 1, I’m on metformin and jardiance no insulin. can someone just say something to make me feel better before I eat a whole tub of ice cream.

 

[Antje77]

If you have been eating very low carb, it may be you produce ketones because of this, which is perfectly fine and healthy.
There's a big difference between ketosis (which is what all the keto-diets aim for) or ketoacidosis (DKA, which is very dangerous and usually seen in T1's.

You are right in thinking DKA usually goes hand in hand with high blood sugars.

However, being on jardiance complicates things: it's designed to make you pee out excess glucose to lower your blood sugars. With this mechanism it's possible to have reasonable numbers but still go in DKA if you're a misdiagnosed T1.

So your nurse is right with her worries, even though chances are you're doing very good.

 

[Jaylee]

Hi guys,
Not really sure where to start as I’m just feeling really down today I had my 3 month diabetic check and my hba1c has gone from 42-57 so I decided to start a low carb diet on Saturday, today I went to see the nurse so she could check my urine and I now have 2 ketones in my urine, I have never had them before. She sent me into a panic as she was saying maybe I am type 1 but my blood sugar levels are 5.8 on waking and 6.5 after food. These readings are since I started the low carb diet. So now I have been told because of ketones in my urine it’s bad for me, but if I eat carbs they are bad for me. I can’t stop crying I just don’t know what I’m supposed to be doing! I just feel like I still don’t have an answer, I’m going to see the doctor next week so she can check my urine again, I feel fine, my blood sugar before I started the low carb diet was around 7-11 not managed great and I’m sure no where near what it would be if I was type 1, I’m on metformin and jardiance no insulin. can someone just say something to make me feel better before I eat a whole tub of ice cream.

Hi,

If your BGs are in healthy perameters but ketones are present. (Also adding your dietary change into the mix.)
That is nutritional Ketosis. A natural phenomena..
Your nurse seemed to have wigged out, forgetting your actual blood sugar levels at the time.

Hope this helps you keep the lid shut on the tub..

 

[ziggy_w]

Hi @Dudette1,

Hugs for feeling confused.

Your nurse really has a lot to answer for. When you cut down on carbs, producing ketones is absolutely normal (it's called nutritional ketosis). While you're switching to fat-burning mode, initially the body expels a lot of the ketones in the urine as it is not yet fully equipped to use them. After a while, most people become more efficient at using ketones and they disappear from the urine (Caveat: While this is what most people see, it unfortunately doesn't work for me, but I am not really worried about this).

If you are worried, you might consider getting a ketone meter (which is a lot more accurate than a urine dip stick) to make sure your levels correspond to nutritional ketosis (blood ketones somewhere between 0.5 mmol to 6.0 mmol (at the higher end of this range if you eat little and add exercise) rather than ketoacidosis (blood ketones in excess of 10 mmol or higher) -- see picture below

This being said, you are really doing great -- reducing blood sugars from a range of 7 mmol to 11 mmol to a lower range of 5.8 mmol to 6.5 mmol is a wonderful achievement. Sorry again that your nurse's comment got you to worry about this.

 

[Dudette1]

Thank you guys the kids is shut and I will not open it she got me in such a state I didn’t know what I was doing wrong. Does anyone know the rough amount of carbs not to go into ketosis? I do not like seeing this woman she always has to ask a doctor never gives me a straight answer. Why couldn’t she say, a recommendation of carbs is.... she was on about sending me to hospital, saying she’s never done a urine sample on someone with diabetes type 2 and then having ketones in. She’s really pee’d me off today. U guys are awsome thank you. What’s people’s carb limit on here if you don’t mind me asking.

 

[Dudette1]

I’m also tempted to stop my jardiance but keep on with my metformin just to prove to her my blood sugars are stable and not sky high leading her to think I’m type 1. Why would she let me keep taking jardiance if there is a risk they might just be making my numbers look good and they could mask that they could be high. So confused

 

[Jaylee]

Thank you guys the kids is shut and I will not open it she got me in such a state I didn’t know what I was doing wrong. Does anyone know the rough amount of carbs not to go into ketosis? I do not like seeing this woman she always has to ask a doctor never gives me a straight answer. Why couldn’t she say, a recommendation of carbs is.... she was on about sending me to hospital, saying she’s never done a urine sample on someone with diabetes type 2 and then having ketones in. She’s really pee’d me off today. U guys are awsome thank you. What’s people’s carb limit on here if you don’t mind me asking.

Hi,

I feel you need to find what works for you. There's been a far few tales of DSNs without a clue..
I omit food wise, certain "suspects" but I balance insulin which is a different story in itself for me.

If you have a meter. That's the best tool you can use to find out what is working.

I’m also tempted to stop my jardiance but keep on with my metformin just to prove to her my blood sugars are stable and not sky high leading her to think I’m type 1. Why would she let me keep taking jardiance if there is a risk they might just be making my numbers look good and they could mask that they could be high. So confused

Logically.
If the drugs prescribed & the diet your doing has remarkably improved your BGs?
I have no idea why your nurse would believe you are T1. The drugs currently prescribed for you would not help if you are..?
Apart from mistaking Ketosis for "Ketoacidocis." But the clue is in the current BGs.

It always worth while to keep an eye on your BGs whatever type diagnosed..

 

[ianf0ster]

Hi Dudette1. Don't worry about the (small amount of) ketones in the urine so long as your BG levels are below the mid teens.
Since you are eating Low Carb it is most unlikely that they would go that high unless you are Type1.

As has been said already, in the vast majority of cases doing Low Carb, the ketones will disappear from the urine once your body is fully fat adapted and so is using them for fuel.
No need to increase you Carbs to try and only just get out of Ketosis unless you want to eat more carbs.

Personally I have no idea at which amount of carbs I come out of ketosis. I suspect that with my daily consumption being between 20ms and 40gms of carbs per day, that I'm in and out of ketosis every day.

 

[Dudette1]

Surely if she thinks I’m type 1 I would need to go to be checked. I’m going to ring the hospital tomorrow and get some clarification on things, and from now on I will not be seeing her no more.feel better already guys, thank you so much for all your help

 

[Resurgam]

What a numpty. Doesn't even know her own 'speciality'.
First of all congratulations, your low cab diet has pushed you into ketosis, you are now burning fat instead of carbs, you should feel a lot better for it and soon see the benefits.
Secondly there is no requirement to eat any carbs at all but they do make a colourful contribution to the plate of food, they bring micronutrients and variety, so as you can test, just check up on your after meal levels once you start to see normal results.
Thirdly - maybe educate the nurse on what a low carb diet does?

 

[Jaylee]

Surely if she thinks I’m type 1 I would need to go to be checked. I’m going to ring the hospital tomorrow and get some clarification on things, and from now on I will not be seeing her no more.feel better already guys, thank you so much for all your help

Logically, if you were testing with high BGs & ketones, let alone expressing visible signs of being unwell. (Listed in the link.)
You should be immediately admitted to a hospital..

https://www.nhs.uk/conditions/diabetic-ketoacidosis/

 

[Dudette1]

What a numpty. Doesn't even know her own 'speciality'.
First of all congratulations, your low cab diet has pushed you into ketosis, you are now burning fat instead of carbs, you should feel a lot better for it and soon see the benefits.
Secondly there is no requirement to eat any carbs at all but they do make a colourful contribution to the plate of food, they bring micronutrients and variety, so as you can test, just check up on your after meal levels once you start to see normal results.
Thirdly - maybe educate the nurse on what a low carb diet does?

I think it’s because she says 2 on the urine test I should be in hospital, I’m just wondering if anyone has had this issue when they started low carb x

 

[ianf0ster]

I think some people have also exper

I think it’s because she says 2 on the urine test I should be in hospital, I’m just wondering if anyone has had this issue when they started low carb x

I think that a few people have mentioned getting this sort of reaction, but fortunately only the minority.
However that may just be because few Doctors test for Ketones unless the patient appears more than a little unwell.

 

[Dudette1]

Ok, feeling more positive today thanks to you guys. I had a call from my doctor and she explained things fully and properly and we decided to stop my jardiance and carry on with low carb and see how I get on. Today my levels before food 5.9-6.2 and after meals 6.1 So going pretty well..I’ve already lost 6 stone and I’ve got one more to go to hit my 11stone target. this disease is so daunting and I thought I had it all in the bag but clearly I am always learning.