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High Ketones, don't know where to start, advice please

K

Karen with a K

Newbie
Messages
2
Location
Midlands
Type of diabetes
Don't have diabetes
Treatment type
Diet only
Hello,
I joined here last week with concern about diabetes with my sister (52). I am not sure where to start or where to write.
I have just wrote loads and deleted it. Basically moved back to family home early last year, relationship ended came back home.
My sister suffers extreme anxiety, panic attacks, bouts of depression and mild OCD.
To get these blood test taken took everything we had. ......
Keeping it straight forward for this post and will give any blood test results as needed.
Oct 2018 HbA1c 68 mmol/mol
Jun 2019 HbA1c 39 mol/mol and
Mar 2020 HbA1c 38 mol/mol

Since lockdown she will not go out. We noticed the last few weeks that after eating she is sleeping a lot, so she did a blood test strip and the readings ranged from 12, 14 and highest was 17 mml/mol this scared her and we said she needs to go to the doctors... she won't. She has now cut down on chocolates, biscuits, bread etc and her numbers have been coming down, last few days before meals are 6.4, 6.1 and even a 5.8 mml/mol and sleeping all the time,

We were so pleased, she was pleased.... now this is where the problem comes back. When numbers were first high we also got her to do a urine stick test and it showed glucose in her urine, as the blood glucose meter test numbers have come down so as the glucose on the test strip..... that is clear, but now there is ketones there, ranging between the highest and next down....

Heres were we need advice - is it okay for these ketones to be there now that the blood sugar has come down...
Will the ketones go away. she did have strange smells in her nose, she says these have virtually gone, coming and going and less often.
My sister is still trying not to eat high sugar food etc., she is eating eggs and ham and this type of thing (she won't be able to keep this up, and says she is doing 'just for now to help get numbers down' - however, even after eating the ketones are still there.
She is drinking lots of water. We have asked her to go to the Doctors, she won't she is so scared of the virus she will not go.

Can I ask, ketones and blood sugar..... has the blood sugar numbers come down because body is using fat to bring them down - hence the ketones or could the ketones be there due to the amount of sugars that have been in body for so long.

I am sorry I have gone on, put I really don't know what to do. All she says is she doesn't want to be a diabetic and will change. owww and another thought would this be anything to do with Type 1.

I know I won't get her to the doctors, although we keep trying, at the moment she just won't.
"Any" and advice would really appreciated, I understand you aren't doctors and the advice you give is your own - I just need help to understand if this will be okay or what to do.

Thank you to anyone that has finished reading this.
 
Hello,
Thank you very much for replying.

No, not classed as a diabetic (I think if she had gone to her doctor back in 2018 she would of been). The first two Hba1C results where private and the last one was the family doctor.... when the results were fairly normal. No diabetic medication, on Atenolol for blood pressure and has condition called Diverticulitis this doesn't cause any issues to date.

Just before lockdown we got her to go to family doctor and she had blood test..... we were thinking this would all come out, however, blood test was good from I'm guessing the walking she was doing. She was really getting into this, but it all stopped with lockdown.

My sister doesn't seem stressed about the ketones, but I have read how serious this can be. I don't understand diabetes - I'm trying to. I keep thinking are her blood sugars down because of her changed diet and her body using fat and not having enough insulin - I just don't know.
 
Eating a low carb diet should not be at all harmful - and if your sister is unable to deal with a modern diet, which tends to be high carb, then low carb might be the best way for her to eat.
With the high Hba1c reading being in the past, and little likely hood of going to the doctor, a diagnosis is unlikely - I suspect that eating carbs would push your sister back into the diabetic range, but we can only say that is something for a doctor to decide.
However - many people who are type two can and do resolve the problem by keeping their blood glucose under control by their diet.
They might well have ketones in their blood, but due to ketosis - which is good, not diabetic ketoacidosis, which is bad. High blood glucose and rapid weightloss, more associated with type one diabetes and high ketone levels are dangerous and require swift treatment.
If your sister is type two then it is not a certainty that she will be suffering from not enough insulin - most type twos start out with too much insulin.
In the circumstances staying with the low carbing - you might find Dr Atkins New Diet Revolution useful, and organizing a telephone consultation with your GP might help to regularize the situation and keep them updated on the blood glucose levels.
 
Your sister, from the sound of it, is in nutritional ketosis. That's fine, and something quite a few T2's use; A ketogenic, low carb diet, to keep their blood sugars under control. I do understand your concerns, but nutritional ketosis is something entirely different from diabetic ketoacidosis. When there are ketones present because someone doesn't make enough insulin, the glucose is high but cannot be used for fuel. The body starts cannibalising itself, going damage to the point of coma and potentially, death, as organs start failing. It's a cascade and that is NOT, from what you're telling us, what is happening with your sister. What you're describing is nutritional ketosis. Speaking for myself, I have been in ketosis for three years or so now. Not dead yet. What I am though, is healthier, with bloods in the non-diabetic range, no longer morbidly obese, and my non-alcoholic fatty liver disease is fixed. She's doing really, really well for herself. You can be proud. And breathe. She's a champion.
 
There are two reasons for ketones. One is dietary ketosis caused by a low carb diet and is perfectly normal and safe. If your sister's blood sugar is normal then this is probably what she has.

The other is diabetic ketoacidosis (DKA) caused by high blood sugars (13 plus, often over 20) accompanied by insufficient insulin, and this is the one you need to avoid.

T2 diabetics typically over produce insulin because they are insulin resistant and just can't process carbs well. It's unusual though not impossible for them to get DKA.

T1 diabetics just don't make enough insulin and hence their blood sugars go up and they get DKA.

The sleeping all the time is a concern though. Could she get a phone consult with her doctor? What are her sugar levels like 2 hours after meals?

Karen with a K said:
Can I ask, ketones and blood sugar..... has the blood sugar numbers come down because body is using fat to bring them down - hence the ketones or could the ketones be there due to the amount of sugars that have been in body for so long.
Click to expand...
The sugars will have come down because she is no longer eating more carbs than her body can process. Insulin brings sugar levels down, but when you have less carbs you need less insulin.
 
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