huge conflict with dietician

[mrman]

Also agree that ketoacidosis can occur even when sugar levels not too high. I had blood tests done at surgery, no phonecall from them after 3 days. I had to phone for my results as I was feeling alot worse by then, battled through receptionist to speak to a gp, my gp who ordered the tests was on hols. My sugar level read 9, high but not considered dangerously high to need to be contacted. He then seen my ketones were extremely raised 5. Something ish. Then told to go straight to a and e, remember this was 3 days later. Current sugar level read high on on hospital meter as did ketones.
Explanation I had was as I was producing a little insulin prior to my cells going caput,but, at the time doing alot of gym excercise allowed my sugar levels to be slightly raised,but, with the lack of insulin developed ketoacidosis.
This is because excercise can lower sugar levels without insulin, but raises ketone levels due to a lack of it.


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[Daibell]

Brett, thanks for the extra info; I hadn't realised ketoacidosis can occur at lower sugar levels.

 

[mrman]

Brett, thanks for the extra info; I hadn't realised ketoacidosis can occur at lower sugar levels.

Didn't think the doc did either lol

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[fatbird]

"Brett, thanks for the extra info; I hadn't realised ketoacidosis can occur at lower sugar levels."

Yes and we can all fly-and win the lottery next week.

FB

 

[mrman]

Ketoacidosis arise from lack of insulin, exercise lowers blood levels. Put the 2 together what do you get.
That were my levels at the docs, and levels at the hospital, just cause its not what you want to hear does not make it impossible, it happened unfortunately to me as I'm sure others.
It is simply offensive to accuse me of lying which just because you don't think it possible. Thought you dealt in truths not ifs. Thats the truth my medical records would back it up. I have never posted stating something that has personally happened to myself which is untrue, as indeed my profile shows true info and pic.

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[fatbird]

Brett in the interest of clarity-please could you repeat the BG number that ketoacidosis occurred-thank you.

FB

 

[mrman]

Yes, I had the on the spot blood reading that morning of a fasting 9mmol, to which the nurse said I was more than likely diabetic (doh, but had no idea about anything then). To make matters worse, they did an on the spot check for keytones, to which showed positive. I was then sent away and told to await blood results which were sent to the hospital. Hospital sent test results to surgery confirming the 9mmol reading but with elevated ketones. My doc whom ordered the tests was away on leave. I got worse, very sick, faint etc. so, when I phoned gp, was only then the ketone level was picked up and I was sent to hospital, which the gp phoned ahead to advise them of my situation. this, being 3 days later my blood sugars had gone from 9mmol to off the meter and had ketones, also off the metet. I was then placed on sliding scale, and also hooked up to a heart rate monitor and sent at gone midnight ***, for a chest x ray.
Result type 1 on insulin.

Long way to say my ketones were very elevated with a fasting reading of 9mmol

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[fatbird]

"a fasting 9mmol," BG number would not get 99.99% of people anywhere near a ketoacidosis situation. You are very unique.

FB

 

[mrman]

Agree, it may of been uniqie. Also the fact I required little to no basal insulin for 12 months once starting insulin says to me I was producing basal, but little bolus naturally. Call it honeymoon period or progressive lada who knows. Thats why in type 1 scenarios or indeed ladas or misdiagnosed type 2s need to be very carefull as things will progress very rapidly at onset of full type 1. that its what concerns me about ever having ketones again. I was just lucky as the hospital nurse said I was possibly 12 hours away from being in a coma. That was only 3 days after. Do I want to be in ketosis again,? like a hole in the head.

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[fatbird]

"Do I want to be in ketosis again,? like a hole in the head." Ketosis is 100% healthy and occurs in all healthy people-probably every day. Ketoacidosis is very unhealthy and can kill.

FB

 

[mrman]

Yes, appreciate the 2 are extremely different but, if in ketosis and my basal rates or bolus ratios were to change or I was to do something different causing a raised sugar level, wouldn't take alot to be in serious trouble whilst already being in ketosis. Since my dx have never shown ketones in excess of 0.3 even when ill.


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[mpe]

The OP is a Type 1. That gives a good indication as to the motives of their dietician.

There is a certain level of insulin that a non-diabetic person would have. That is enough to handle a normal amount of carbs.

If a Type 1 injects a similar amount of insulin, they are as close to normal as they can get. This has the effect of reducing the impact of any error in insulin dosing. A 1 unit error on a 1 unit dose is much more significant than a 1 unit error on a 5 unit dose. Hence the advice not to low-carb.

Actually someone who's not diabetic would automatically adjust the amount of insulin they produce/release into the bloodstream.
There's also Dose Adjustment For Normal Eating (DAFNE) which means that diabetics taking insulin can adjust the amount of insulin they inject depending on what they eat and/or their resulting blood sugar levels.

That's before even considering that the GDA carbohydrate level may not be "normal" in the first place.

 

[mrman]

Yes dafne teaches adjustment for carbs eaten. also advise changes to make for activity, current level, temperature, illness etc. also, 100% agree less carbs eaten less margin of error. Error there none the less weather it be 1 or more units.

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[fatbird]

Brett said.

"100% agree less carbs eaten less margin of error."

Back of the net, you're getting there Brett.

FB

 

[mrman]

have never said it wasn't lol, just that if you know how to reduce the margin of error all the better

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[mpe]

Hi Sip,

You hear that a lot; but it's simply not true. Google 'essential nutrients' you'll see that there are no carbohydrates on the list. 'Essential' means nutrients that cannot be created by the body. It is true that you need about 30 grams of glucose a day (for elements of brain function and some muscle function) but our rather astonishing bodies can synthesise that from protein; by gluconeogenesis.

Not even lactating women need any dietary carbohydrates.

So, if you want to be super hard core you can eat zero carbs a day without problems (as long as you are eating the essential nutrients). How palatable that would be is another question...

There are plenty of examples of people living for extended periods on such a diet. Including the traditional Inuit and Maasai diets.

If you are low carbing your body will switch from a glucose metabolic state to a ketotic state; it will break down fat to provide energy and you will have low levels of ketones show up in your blood.

The primary method of fat respiration is called "beta oxidation". The production of ketones is primarily due to the Blood Brain Barrier. Which limits what compounds neurons can get into their mitochondria from the blood to those below a certain size. IIRC it is possible for certain fats, such as propan-tri-butanoate, can cross the BBB. But the liver needs to specifically make these. Which it generally only starts doing after several days of low dietary glucose.

 

[fatbird]

The earliest and primary proponent of an all animal-based diet was Vilhjalmur Stefansson, a Canadian explorer who lived with the Inuit for some time, and who witnessed their diet as essentially consisting of meat and fish, with very few carbohydrates - berries during the summer. Stefansson and a friend later volunteered for a one year experiment at Bellevue Hospital in New York to prove he could thrive on a diet of nothing but meat, meat fat and internal organs of animals.

His progress was closely monitored and experiments were done on his health throughout the year. At the end of the year, he did not show any symptoms of ill health; he did not develop scurvy , which many scientists had expected to manifest itself only a few months into the diet due to the lack of vitamin C in muscle meat. However, Stefansson and his partner did not eat just muscle meat - they ate fat, raw brain, raw liver (a significant source of vitamin C and others), and other varieties of offal. The no-carbohydrate and low carb diet often reverses type two diabetes.

Google this man a good read.

FB

 

[mrman]

Google ketoacidosis with a normal blood sugar level while your at it

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[mpe]

Ketosis is 100% healthy and occurs in all healthy people-probably every day.

Possibly not that many people now with the kind of glucose heavy diets which are encouraged. But almost certainly the case 50-100 years ago.
Also ketosis has been observed in aves (birds) as well as mammals. So is obviously an ancient metabolic pathway.

Ketoacidosis is very unhealthy and can kill.

It's a serious metabolic malfunction. Especially given that blood pH is both "buffered" and actively regulated.

 

[fatbird]

"Google ketoacidosis with a normal blood sugar level while your at it"

Brett please can you direct me to where healthy people with normal blood glucose levels suffer from ketoacidosis.

FB