Ketone question...

[claridge]

Hi,
I posted this in the Type 1 section but did not get a response so thought l would try here.
I am type 1 since Feb, low carber, avid exerciser and last HBA1C was 5.6%. My docs are really happy but l think want to mak sure the low carbing is not having any adverse effects so have given me a new monitor to check my Ketones. I have only tested once... a few days ago and it was 1.0. On the pack it says that they should be below 0.6%. I do not fully understand yet about the Ketosis state and l assume that is why my Ketones are a little bit higher? I just wanted to make sure this was okay and get some further information before l go back to my docs.
Thank you all in advance x

 

[diabetesmum]

Hi Claridge,

My understanding is that provided you have enough 'background' insulin, then a small amount of ketones is not going to cause you any problems. There is sometimes confusion between 'ketosis' and 'diabetic ketoacidosis' (DKA), even amongst medical professionals. There are other threads on here you might like to read, I would post the links, but don't know how , maybe if you do a search?

Anyway, the basic story is that it is a relative lack of insulin that causes uncontrolled production of ketones in the blood, which (usually) combined with high blood glucose levels, causes the blood to become acidic, leading to blood poisoning, DKA. So, provided you are not running short of insulin, your few ketones will not be dangerous to you.

The state of ketosis caused by low carbing is not a problem provided you have enough basal insulin in your system and low (ish) blood glucose levels. We have been given guidelines that say a BG of 14 or over combined with blood ketones of 0.7 or more should alert us to check if there is a problem brewing. So perhaps your Dr may get a bit jumpy if your ketones run consistently at 1 or over, but my feeling is still that provided you are getting the correct amount of insulin always, you should be okay. However, you need to have a chat with the Dr once you have had a further read up about it all, I think. Hope this helps.
Best wishes,
Sue

 

[fergus]

I'd agree with Sue.
Provided your blood sugar levels are good, there is nothing to worry about. Ketones are simply a sign that the body is doing what it should - using fat for fuel.

All the best,

fergus

 

[Dillinger]

Hi,

I'd agree with Sue and Fergus ; low level ketosis is ideal. Below is a bit from the arguments for a low carb diet sticky in the Low Carb section about this.

All the best

Dillinger


Ketosis is not the same as Ketoacidosis and is a normal metabolic response to low carbohydrate content in the diet and/or fasting where insulin is present. It occurs at a mild level with insulin present at low or non diabetic insulin levels.

Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of ketone bodies formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced are acetoacetic acid and β-hydroxybutyrate.

Ketoacidosis is an extreme and uncontrolled form of ketosis. In ketoacidosis, the liver breaks down fat and proteins in response to a perceived need for respiratory substrate (i.e. where no insulin is present to metabolise glucose even though high levels of glucose are present) causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased.

Insulin inhibits ketosis and therefore a diabetic on a low carbohydrate diet (with an appropriate insulin regime) will not develop ketoacidosis but will merely display trace or low levels of ketones produced via normal metabolic ketosis.

On a low carbohydrate diet we aim to achieve low level ketosis and there are no studies to suggest that ketosis has any detrimental effect on liver function or other negative health implications.

 

[claridge]

Thanks guys- it still doesnt say what levels our Ketones can be at to be considered safe though so will just keep an eye just in case it does go up for any reason.

 

[hanadr]

DKA makes you feel lousy
so a trace of ketones, good Bg( about 4.5 - 5 ) and feeling well. no worries.