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Hypo's & Hyper's

Dragonflye

Dragonflye

Well-Known Member
Messages
235
Location
Bradford
Type of diabetes
Type 1
Treatment type
Pump
Hey guys!!!

I can't believe im asking this... I have been diabetic for coming onto 23 years now and have never before really paid much attention to ketones... however now im on the pump i finally have ketone sticks and am testing...

I was wondering, last night I had a huge hypo, that required hubby to inject glucogon and then took an age to come round... i did the testing every 15mins etc after glucotabs and finally got it sugars to 5.4... just over 1 hour later got to work and about to do brekky so tested and 14.4 :shock: didn't feel rubbish so didnt check ketones and had my insulin as normal... 1.5 hours later gone down to 12.5 - still higher than expected but now i was feeling rubbish so decided to check ketones and the colour on the bottle showed 8!!!!

still battling to get sugars down but wondering if this is normal?? :oops: :oops: :oops:
 
Hi Dragonflye,

By ketones of 8 do you mean inbetween trace and small? If so, then that's to be monitored but immediately dangerous. If it's higher, then that could be a problem.

The advice given to me was high blood sugar plus high ketones = seek medical advice. If you're still running high, definitely speak to someone. You may also be sickening for something that hasn't yet fully hit you. Have you been told your sick day rules?

Drinking lots of water may help with the ketones, but definitely don't do any strenuous exercise with high sugars and ketones.

This is from the DUK website
http://www.diabetes.co.uk/diabetes-and-ketones.html
I am diabetic and my ketone test is positive, what should I do?
Contact your healthcare team, and explain the situation to them.

Should the tests show very small amounts of ketones take the following actions:

Drink water every hour, and continue testing every three hours.
Do not exercise.
If your ketone levels do not fall after two tests contact your healthcare team.
If the test shows moderate or high ketone numbers then telephone your doctor at once, and drink water
Click to expand...
 
On the colour code thing on the tub of ketostix 8 is not the highest, but the 1 below!! I am aware that when sick insulin requirements may go up, ill have to read pump manual about temp setting a higher basal amount :)
lucky my job is sitting at a desk all day, so the most strenous thing I have done is walk to the loos :)
home now and doing a full change, insulin/tubing and cannula as im not sure if there's something wrong with the batch i have (the tubing feels weird of the 1st 2 i have had out of box) and the sticky bit on the cannula's aint sticky!!!!
Bah does that mean I shoulda called docs?!? ooops will remember for next time, don't think it would have gone down well going home from work early as I'm only in 1 day a week on keep in touch days until my maternity leave finishes on 31st July!!!! :(
Good thing is though ketones have finally gone down to trace even with sugars averaging on 13 or 14 :)
 
Hope the change over soon gets them levels down Dragonflye!

Nigel
 
I can't answer about the ketones because I've never tested for them either (even in 36 years! :oops: ) but a blood sugar of 12 or 13, while not ideal, is not unusual for a post hypo kick, especially one as serious as yours sounded. DAFNE advises that you do not compensate for post hypo highs because they should come down on their own. Unless of course you ate far more than you should have to deal with the hypo, but that's another story.
 
In the past month since being on the insulin pump, I have been lucky in that my post hypo results have been around the 5 mark, this is the first time it's gone above 6... I have never needed to go on DAFNE or any other course :) however I have always been aware when on MDI not to compensate :) to be honest not sure wether or not on the pump i DO need to compensate, however i did on this occasion which is lucky as i dread to think how high my sugars would have gone if i hadnt :)
The only thing im doing different now for hypo's is just having 15g fast acting carb (glucotabs, glucogel or glucogon if its a bad 1 like last night) - i no longer need to have additional carbs once im out of hypo :) - this is what i've been told from DSN and it seems to be working for me :) (about the only thing that is working :D )
I think I've always had ketostix in the house, my dad actually diagnosed me when i was 4 (he was a late onset t1) and my parents used to use them for me when i was younger - however since ive been in control of my own prescriptions and such for some reason I never thought about them until now :oops:
 
Maybe the ketones were due to the glucagon? It makes your liver dump glucose, so its effects could be different from just treating with carbs. Or maybe it's because you have a set or delivery problem as you mentioned on the pump forum.

Hope you get things sorted out soon.
 
Hi Dragonfly,

hope you got things going a bit better.

As your only using rapid insulin with a pump, your chances of developing ketones are higher as quick acting insulin only has a life of around 2-5 hours.

You definately 100% need to COMPLETELY ditch the ketones sticks that use urine!!!!!!!!!!

Using urine for ketone testing is not very accurate, it takes a while for the urine to pass through your body so the result it shows means it could have changed rapidly since then, especially as i mentioned you are only using quick acting insulin.

you NEED NEED NEED to have access to testing your ketones with blood, as far as im aware there is only one meter that does this - the optimum Xceed.

the first thing my nurse did with my prescription when i started pumping as to change from urine ketone testing to blood ketone testing, she really made it clear that it is imperative you are able to accurately test ketones so you can act on any positive results ASAP.

I don't in anyway mean to worry you, but it's what flashed in my mind when i read your post that you really should be testing with blood for ketones when pumping.

as said before, drink plenty of water, if you have ketones your body will be working hard to try pee/sweat them out, so keep yourself hydrated. Definately DONT exercise as this is likely to make the ketones and high BG's worse.

I use sick day rules as taught on the DAFNE course. I'm not sure if you know these but it would be a good idea if you could find out if you don't.

i have my sick day rules stuck on the inside of my wardrobe so i ALWAYS know where they are.

If i was showing VERY high ketones and high BG's i would use my sick day rules. I would also use an insulin pen for a correction dose, then you KNOW your getting your insulin. If still no change or if they are climbing, i would go straight to A&E!! especially if i start to vomit or feel very unwell alongside high readings.

Check your pump for leaks, breaks, bubbles. Change your set and tubing if necessary and even change your cartridge.

NEVER be afraid to seek medical help, i hear of far too many people who hold off on medical help because they are worried they might be wasting someones time, or that they don't feel it's 'bad' enough to go to A&E or call NHS direct.

Again i'm sorry if i sound over dramatic or anything but i'd rather do the whole hog and it not be needed than not say anything if you did need this sort of advice.

Hope it's all sorted. again please please try sort out ketone blood testing, and anyone else who's reading this who is pumping, you need to do it too! urine testing is not quick enough to act on when you are only using quick acting insulin and no long acting insulin.

EDIT - also, when testing don't leave it for 3 hours, this is more than enough time for your insulin to wear off, if i have a reading 14+ i will test every HOUR to see if it's falling. Also the same with ketones.
 
the last time i had ketostix on prescription was when i was about 15!!! moved changed gp's and never had them since... it was only when the hospital changed my prescription to add the insulin vial that they also added ketostix back on!! plus my doctors refuse to prescribe 2 seperate types of test strips :)

i never leave testing 3 hours :) the longest has been 2 hours, but usually on average do it about 1 to 1.5 hours after correction :)

i did a complete change when i got home and by 9pm everything had finally settled down :)
 
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