High Ketones and Sugar in Urine

This morning i had my normal diabetic blood test and urine sample taken by my GP.

I got a call back from the nurse asking me if i was ok?, she then went on to tell me about the ketones in my urine (she said the strip she used had 3+++ on it) ,and that she also found some sugar in there.
I explained to her that i had just come off a 24hour fast this morning and that my sugars were 8.8 mmol on wakening(usually in the high 6s or low 7s but i digress)

I straight away did a blood ketone test and it was 2.5 which is a little high but thats down to doing no carb/carnivore.

I have to wait until monday to get the blood work results..but i am a worrier and am just seeking re-assurance to see if anybody here have ever had similar experiences.
Thanks for reading that wall of text haha.

HSSS said:

I’d expect to see similar ketones when on a very low carb /carnivore diet and especially after a 24hr fast. A little surprised to see glucose a little elevated though but potentially just dawn phenomenon/ liver dumps kicking in. Presumably you’re eating again now?

Sometimes a nurse has never seen this happen, but has seen DKA, and worries as a result. As you have the means I personally would just keep an eye on it over the weekend in an abundance of caution til you get the actual results. Obviously if you feel unwell or ketones or glucose continue to rise then reconsider the watch and wait and seek professional advice sooner rather than later.

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Thanks for the reply..yes i have eaten an hour ago and just tested myself now and my sugars are 6.7mmol and ketones have gone down a bit to 2.1.
and your right about the poor nurse..she probably thought i was just gonna keel over and go into a coma as she maybe thought KDA.

Antje77 said:

Are you still on Forxiga?
Forxiga (dapagliflozin, an SGLT2 inhibitor) is a medication designed to let you pee out excess glucose.
It's also a medication that can mask DKA because BG can stay pretty much normal even if there's not enough insulin so the nurse was right to be worried.

There's nothing wrong with dietary ketosis, but the combination of this medication plus ketones is usually alarming, most people are not in dietary ketosis after all.

Euglycemic diabetic ketoacidosis caused by dapagliflozin: A case report - PMC

Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked ...

www.ncbi.nlm.nih.gov

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Yep im still on forxiga and had forgotten about the glucose being pushed into the urine..thanks for the reminder.