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Is body in Ketosis overnight dangerous ?

K

KelvinLi

Newbie
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3
Hi All,

I'm a newly diagnosed diabetic (T2 on insulin) and I have been trying a low-carbs dietary plan for months in an on and off manner. I don't really know when my body has been in Ketosis and for how long at each time because I usually only had less than 1.5 mmol/L ketones in my first morning urine.

However, this morning, my Reagent Ketostix test strip showed about 4 mmol/L (++) ketones. My BGs were OK, 6.0 before going bed and 6.5 before breakfast so it couldn't be Ketoacidosis though I don't know why I suddenly had that much ketone just over one night, maybe it is because I had trouble with my sleep last night.

My question is, is it dangerous to let my body go into ketosis in such an amount overnight, is this amount of Ketone typical ? I know the difference between Ketosis and Ketoacidosis, but it's no like during the day I can just drink a lot of water to flush the ketones out of my body. I'm really worried whether this is going to cause my blood dangerously acidic over night ?


Thanks,

Kelvin
 
Hi Kelvin,

I asked my consultant last year about ketones in the urine, and he said as diabetics have a higher risk of kidney disease, ketones should be avoided as far as possible. I know some will say that this is not the case, and ketones are not harmful, but I am only going by what I have been told by my present consultant and those that served before him.

Regards

Nigel
 
Hi Kelvin,

The basic difference between Ketosis and ketoacidosis is insulin; if your blood sugars are low and you have ketones then you must also have an appropriate level of insulin in your blood.

Ketosis is a normal metabolic condition and is not dangerous; elevated blood sugars plus ketones are the hallmarks of ketoacidosis and that can be dangerous and needs immediate intervention.

The thing with ketosis is that it isn't like turning on a switch; it won't happen immediately and will be stopped if you eat enough carbohydrate for your body to 'think' it is able to metabolise glucose without needed to switch to the 'alternative' fuel supply of fats.

Possibly your higher readings were because you had fully gone into a ketotic state?

If you swap from low to higher carb you will affect how and when (and possibly whether) your body goes into a ketotic state though; that's why on diets such as the Atkins you go on a 2 week strictly low carb diet to ensure you are getting a ketotic response.

As a Type 2 you probably don't need to be in ketosis to have beneficial effects on your insulin production, but if you want to get the blood lipid benefits and the weight loss benefits then it's something to aim for.

All the best

Dillinger
 
noblehead said:
I asked my consultant last year about ketones in the urine, and he said as diabetics have a higher risk of kidney disease, ketones should be avoided as far as possible.

Nigel
Click to expand...

Hi,

This comes up a lot; and not wishing to offend you or your consultant but are you sure that's what he said?

What is the association between ketones (from ketosis) and kidney damage? Ketones from ketoacidosis would indicate very high blood sugars and a changed blood ph which would cause problems for the kidneys and pretty much everything else, but how can ketosis harm anything?

As I understand it ketones are the preferred fuel of the skeletal muscles, the heart, and the liver and if that is the case how can they then be damaging at the same time?

I can't find anything on a quick google of 'kidney damage ketones' to answer those questions.

Dillinger
 
Kelvin,

As ever, should you be in doubt, your best bet would be to speak with your diabetes consultant or gp who are suitably qualified to offer advice, hopefully they will put your mind at ease.

Best wishes

Nigel
 
I think you should watch those ketone levels carefully contacting your doctor for advice if they have not gone down during the day.
You say that you are recently diagnosed and type 2 but are on insulin. You are also being investigated for MODY so really you don't know what type you are. It is possible that you are in fact insulin deficient (even possibly a form of type 1)in this case ketones can build up very quickly. I know I've been there.

Whilst DKA is normally associated with high bgl there is also such a thing as euglycemic ketoacidosis. (ie ketoacidosis at normal bgl) It's rare but I have read that it happens sometimes when people haven't been eating sufficiently or have been vomitting.

Actually it sounds as if you are having your diagnosis investigated at a specialist clinic, I would do as Nigel says contact them for advice.

As to the ketones being benign this is what an NHS website says
Because long periods of ketosis can be dangerous to your kidneys and liver, ketogenic diets are never recommended by health professionals for more than short-term use, typically no longer than 14 days. Many nutritionists warn their patients - especially women in the early stages of pregnancy - against following them at all.
Click to expand...
http://www.cks.nhs.uk/patient_information_leaflet/ketosis#
 
Kevin

What were you levels like for the several days before???? Remeber it can take time to flush out ketones if the body has started to go into DKA at any one point and the situation has been recified..

It is possible to get DKA with lowish BG's I know it happened to me and I ended up spending almost a month in hospital My BG hadn't gone above 8mmol/ml, but I started to vomit etc, didn't think much about it, and it was only a off chance visit from my midwife, that I realised I was in trouble, I actually thought that I caught a playground bug off my daughter as my BG was pretty normal...

I was sent to hospital, put on a sliding scale for almost a fortnight, then I wasn't allowed home until my urine was clear of ketones for 24 hours... And believe me it's the real pits, when you hope of going home are up, as you get near to the 24 hours mark, and no ketones only to find that the little blighters reappear at the 23 hour mark and you got to wait until they clear and start all over again :evil:

If you are on a low carb diet (extremely low carb) then perhaps having a normal range bg and a very low level of ketones, may be the diet..

But after expercining low level BG's and ending up DKA even though it was almost 19 years ago, I still remember it very well, and I personally wouldn't rely on some on the internet saying 'it nothing don't worry' exspecially if I had top marks on the ketone stick I would be off to seek medical advice...

Once you expericend DKA you won't want to suffer it again in a hurry..
 
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