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Ketone Meters

J

JJ2026

Member
Messages
21
Type of diabetes
Other
Treatment type
Insulin
Hi there,

I have the fruity breath associated with ketones however I don't have any of the other symptoms. I looked into getting a ketone meter however they only come with 10 strips and extra strips are costly and financially, I am unable to pay for these. What are my options, please? My diabetic nurse can only be seen monthly although at the moment, the next appointment is July!

JJ.
 
15.0

I took 2 novorapid units over an hour ago and I was at 15.1 then, so they haven't dropped me at all. Blood sugar high all day.
 
Can you phone your diabetic nurse for an opinion? They maybe able to test you or give you a meter to see how high your ketones are. Or if not call 111 and see what they advise.
 
Have you considered urine ketone strips? Much cheaper than the blood ones and more of them in the pack. I know the blood ones most people prefer but if cost is an issue I think I’d take any I could get
 
When my blood sugar goes over 11 I get insulin resistance, and I need more than my usual correction dose. It also takes longer for bloods to start dropping, the higher the blood sugar, the longer. Have you been given advice on correction doses?

It takes time to find out how much basal (long-acting) insulin you need when you're first diagnosed, and it's usual to start on a fairly low dose, and for this to be gradually increased by the HCP you see for diabetes.

As a type 1 you should be able to get a blood ketone meter, and strips from your surgery, with the strips on your repeat prescription.

If 111 don't get back to you soon, and your bloods remain high with fruity breath, I'd suggest going to A&E. Not wishing to scare you, but it can soon turn into DKA, which is very serious.
 
JJ2026 said:
I looked into getting a ketone meter however they only come with 10 strips and extra strips are costly and financially, I am unable to pay for these
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May not help just now, but I think if you are on insulin you should get them free on prescription.

I certainly get them free and when diagnosed that I was told (and it was stressed fairly strongly) that I should always make sure had ketone strips available.

With 10 in a box and doing a test every few months (and usually getting either 0.0 or 0.1), I wasn't worried that I was down to my last two or three. Then one day I needed them and discovered that once my levels went over 1.5 I was supposed to test every 2 hours.

High ketones or even possibly high ketones are not to be ignored and as others have suggested, try your diabetic nurse, 111 , your local pharmacy and if none of them can help, then go to A&E.
 
Hopeful34 said:
Have you been given advice on correction doses?
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None at all. It's all been about where blood sugar levels are, so for exxample if I want to eat and my blood sugar is at 7 then no more than 1 unit of fast-acting insulin. If I am at 11 then no moe than 2 units.
 
I went to my GP yesterday evening who administered a ketone test and that came back as below 0.6 which was good. I asked him while I was there if he would put in a referral for me to see a specialist on diabetes and he was reticent to do that. I can get an appointment for the 16th June but it needs a GP referral. Can a GP refuse this? On what grounds?

Anyhow, I left somewhat reassured by my ketone reading. My blood sugars dropped from 10.7 to Lo (below 1) in just over an hour and a half, between 8.20pm and 9.55pm. I called 999 and the paramedics arrived. I was in a very strange place, mentally. I couldn't string a sentence together. Couldn't put my thoughts into order. They got me back up to where I needed to be and stayed with me until I stabilised but when they were gone, I decided to stay awake all night in case it happened again, which it did. Not down as far but still down below where I needed to be.

This only happens at night. Within an hour of the Lantus pen, my blood sugar drops like a stone. Last night however, it dropped so fast it scared me. 6 units per hour. It took until 4am to stabilise down to 1 unit per hour. The hospital has given me the leeway to experiment with the amount of units but if I go higher (25 units) I get the massive drop and it stays like that for hours. If I go lower, I don't but then I wake up with my blood sugars at 12 or 13, which isn't good. The Novorapid doesn't drop me at all, anymore.

I nearly died last night. I may have to just sleep all day and eat like crazy at night. I can't think of any other way. I have had 3 crashing down hypos in 2 weeks. The thing is, in the hospital, I never went below 5.8 or above 15.9. When I awoke, I was always at about 6.5. What on earth am I doing wrong?
 
It's possible that you experienced a 'Lantus Low'.

You might want to split your Lantus into two doses.
With insulin glargine (Lantus and a couple of other brands) it's possible to have it act like a very fast acting insulin if you hit a capillary. With two injections at least you won't have the full dose acting right away.

It happened to me shortly after having been diagnosed, and for me it was the reason I switched to Tresiba. My practice nurse had never heard of this effect and didn't really believe me, but she did agree to prescribing Tresiba.
JJ2026 said:
I nearly died last night. I may have to just sleep all day and eat like crazy at night. I can't think of any other way. I have had 3 crashing down hypos in 2 weeks. The thing is, in the hospital, I never went below 5.8 or above 15.9. When I awoke, I was always at about 6.5. What on earth am I doing wrong?
Click to expand...
You're not doing anything wrong, you're just newly diagnosed and you don't have all the tools yet to deal with a sometimes unpredictable condition.

Take it easy today after your horrible night!

Lantus: Lethal or Lifesaver? #DOC #gbdoc | Diabettech - Diabetes and Technology

SummaryFollowing issues I experienced with Lantus (Insulin Glargine) in November 2014, I spent some time researching it, looking at absorption and pharmacokinetics and other users' experiences. I reached the conclusion that Glargine has the potential to be lethal and that due to its...
www.diabettech.com www.diabettech.com
 
JJ2026 said:
went to my GP yesterday evening who administered a ketone test and that came back as below 0.6 which was good. I asked him while I was there if he would put in a referral for me to see a specialist on diabetes and he was reticent to do that. I can get an appointment for the 16th June but it needs a GP referral. Can a GP refuse this? On what grounds?
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Yes they can refuse but they need to have god reason - not sure if this is any help

www.nhs.uk

Referrals for specialist care

You're entitled to ask for a referral f or specialist treatment on the NHS. But whether you'll get the referral depends on what the GP feels is clinically necessary in your case.
www.nhs.uk www.nhs.uk
 
lovinglife said:
Yes they can refuse but they need to have god reason - not sure if this is any help
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It is. Thank you. I think it was professional pride because in a way, I am stating I am not happy with the advice I have been given via the surgery's diabetic services, which are woeful to be honest.
 
Antje77 said:
You might want to split your Lantus into two doses.
With insulin glargine (Lantus and a couple of other brands) it's possible to have it act like a very fast acting insulin if you hit a capillary. With two injections at least you won't have the full dose acting right away.
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I am absolutely terrified to be taking it tonight. I have very little fat left on my body, and in the hospital I had a fair bit of belly fat and wondered if that is affecting things at the injection site? I spoke with the NHS diabetic team and they made an appointment to see me on Tuesday morning but I'm not sure I'm going to make it, to be honest. I almost didn't survive last night.

I have been taking 24 units of Lantus but they agreed to knock it down to 20. Does that mean, I can take 10 this evening and then 10 tomorrow morning? The problem is the lower the Lantus, the higher the blood sugar in the morning. Although I suppose it's better to be high than risk a deadly hypo. I am going to have to eat a massive meal before taking it and then a sizeable meal every hour afterwards.

I'm getting a different CGM on Tuesday. Freestyle Libre didn't work for me. False alerts of being too low. Inaccurate readings. They are going to fit me with Dexcom. Also, changing me to Flasp rather than Novorapid. Should I also ask about Tresiba? Although that can cause hypos too, from what I have been reading.

Antje77 said:
Take it easy today after your horrible night!
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I don't know if I can, to be honest. I might not be here tomorrow. That's how I am feeling right now about things. I didn't think I would survive 5 days in ICU then 26 days on a surgical ward, to potentially die at home, with all the supposed safeguards in place. I'm sorry to be such a misery.
 
I will just caveat my comments by saying I’m type 2 no it 3c, so what works for me may not be right for you.

I suggest you go to your appointment with a list of written questions. One might be on splitting the Lantus dose. It works for me, but I did it because Lantus wasn’t working the full 24 hours. It might be a better option for you to avoid the lows, or the specialist might consider a different basal insulin.

I’d also ask about when the best time is to take Fiasp. I’m on that insulin, I was told to take it 15 minutes before a meal. It is a fast working insulin. I find it is very good, but if I do go high it takes more insulin to bring it down, compared to the amount I need to take to stop it going high in the first place.

Ask about how to calculate the right dose. Most people will do that by counting the carbs in each meal. As someone said on another of your posts the NHS run courses for carb counting (and there are apps to help).

Finally well done for being persistent and getting the appointment.
 
Lakeslover said:
As someone said on another of your posts the NHS run courses for carb counting (and there are apps to help).
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At the moment, it's just about avoiding the potentially lethal hypos. The diabetic nurses will take me through care-counting at my appointment, on Tuesday.

I was told by the paramedics yesterday that going hyper (although not great) is better for you until you see the diabetic team than risking another sub 1 blood sugar low, which could polish me off. So for now, I am keeping my carbs higher than usual to counteract these crushing lows.

I took my Lantus at 7.00pm. 10 units and ate immediately after. I will check my blood sugars an hour after. Then an hour after that. Then an hour after that. My fingers will be sore but Tuesday, I will be on Dexcom.

Lakeslover said:
Finally well done for being persistent and getting the appointment.
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Thank you. This is all new for me. None of this was on my bingo card for any point in my life but I've met such great people, since being on the journey.
 
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