Hello, new user here.
I am a T2D with anti-GAD antibodies, so likely will be Type 1 someday, but still measuring high C-peptide levels.
I have mitochondrial disease, so even with high insulin levels, I do not really use carbs very well.
My current meds are Glipizide, Lantus (insulin glargine), and Farxiga. Even as such, my diabetes is not well controlled. (Fasting numbers are OK but spikes are too high)
A few years ago, before starting Lantus, I measured my first ketones per urine, not being on a keto diet. I purchased a ketone blood meter. In a couple days the ketones went away.
Two years ago, the ketones returned and were quite high per urine test strips. (measured the highest on the strip at 16mmol/L). When measured in the blood they were elevated, but not nearly as much at 1.6mmol/L. I was instructed to go to the ER, where the ketones were noted at high levels, but the blood was not acidic, and I did not have any normal DKA symptoms above my normal. I am short of breath from heart failure and breathing muscle weakness steady state).
I was told to discontinue the Farxiga which at the time left me with only Glipizide which proved inadequate to control my blood sugars. The ketones washed out in a few days off the Farxiga/ My endo then added Lantus which has been slowly increased over the years (Current dosage is 120u/day). Even on Lantus, control had been poor. After a few months it was thought to add Farxiga back into the mix, now that I had injected insulin to possibly cover any insulin deficiency I had. I did not get the control I liked, but it was much better on this drug.
One week ago, the ketones returned. I am not on a low carb diet. I have a good amount of insulin, Levels per blood max at about 1.7mmol/L in the morning and then fall through the day. My endo and cardio are reluctant to remove the Farxiga as it is known to have beneficial effects in heart failure and chronic kidney disease. It feels a bit like walking a tight rope though where ketones could run away. Most of the literature online is not very nuanced in this area, stating any ketones in a T2D is cause for alarm.
How many ketones are too many ketones?
I am a T2D with anti-GAD antibodies, so likely will be Type 1 someday, but still measuring high C-peptide levels.
I have mitochondrial disease, so even with high insulin levels, I do not really use carbs very well.
My current meds are Glipizide, Lantus (insulin glargine), and Farxiga. Even as such, my diabetes is not well controlled. (Fasting numbers are OK but spikes are too high)
A few years ago, before starting Lantus, I measured my first ketones per urine, not being on a keto diet. I purchased a ketone blood meter. In a couple days the ketones went away.
Two years ago, the ketones returned and were quite high per urine test strips. (measured the highest on the strip at 16mmol/L). When measured in the blood they were elevated, but not nearly as much at 1.6mmol/L. I was instructed to go to the ER, where the ketones were noted at high levels, but the blood was not acidic, and I did not have any normal DKA symptoms above my normal. I am short of breath from heart failure and breathing muscle weakness steady state).
I was told to discontinue the Farxiga which at the time left me with only Glipizide which proved inadequate to control my blood sugars. The ketones washed out in a few days off the Farxiga/ My endo then added Lantus which has been slowly increased over the years (Current dosage is 120u/day). Even on Lantus, control had been poor. After a few months it was thought to add Farxiga back into the mix, now that I had injected insulin to possibly cover any insulin deficiency I had. I did not get the control I liked, but it was much better on this drug.
One week ago, the ketones returned. I am not on a low carb diet. I have a good amount of insulin, Levels per blood max at about 1.7mmol/L in the morning and then fall through the day. My endo and cardio are reluctant to remove the Farxiga as it is known to have beneficial effects in heart failure and chronic kidney disease. It feels a bit like walking a tight rope though where ketones could run away. Most of the literature online is not very nuanced in this area, stating any ketones in a T2D is cause for alarm.
How many ketones are too many ketones?