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Ketones and BS at 6.8 ?

Danaemac

Well-Known Member
Messages
234
Location
Dunfermline
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
People who think they know what you need before you do
Hi Guys

Need some advice I have a friend who is type 1 we both started on our pumps at the same time but she is not a member on here as far as I know who has phoned to say her readings yesterday were between 5 - 7 but with 0.2 - 0.4 ketones again this morning 6.8 0.2 ketones I know this isa low amount but does anyone know what causes this or how to get rid of them we know sick day rules but there is no high bs to treat just ketones to worry about she says she's feeling exhausted and a bit under the weather could she just be sickening for something

Any help as always appreciated

Stay well

Danae
 
she could be heading for DKA. is she thirsty and weeing alot.if she is and along with exhaustion and feeling under the weather. if so get her to a&e and on a sliding scale. don't take any chances, i've been there...hope she's better soon
 
She says she's been drinking plenty but not going to the toilet any more than normal but she's drinking to try and flush them out rather than being thirsty
 
According to the information my hosp provided me when I went onto a pump ketones of below 0.6 are classed as within the normal range and I shouldn't worry about them.
 
Just managed yo get hold of the DSN and she has put her mind at rest and said the same thing u have Riri

Sent from the Diabetes Forum App
 
Just to let you know - my dsn said the same thing as I constantly have 0.1 - 0.3 ketones. She said it's normal after longer fasting period, like sleep but if they're not going up and are below 0.6 there's nothing to worry (when your bg is in range, obviously).
 
This link by a US research medic may be of interest. Some LCHF followers, especially athletes, aim to be in mild ketosis 0.5 to 3.0. This is know as nutritional ketosis and indicates fat burning as the body's major energy source. But medical guidelines typically want insulin dependent diabetics to stay below 0.6 or 1.0 at highest, as it is possible to rapidly progress to life threatening ketoacidosis usually levels above 15 mM. At my last DKA admission my blood ketones reached 30 . Fortunately back under 1.0 within 24 hours, but too close for comfort!

http://eatingacademy.com/nutrition/is-ketosis-dangerous
 
The guidelines for DKA state that
DKA is characterised by hyperglycaemia, acidosis, and ketonaemia:
  • Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks).
  • Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of diabetic ketoacidosis and the blood glucose may rarely be normal or only slightly elevated in DKA).
  • Bicarbonate below 15 mmol/L and/or venous pH less than 7.
Severe DKA is categorised by several indications but includes
Blood ketones above 6 mmol/L

 
From my readings on deliberately induced nutritional (intentional fat burning) ketosis it is hard for non diabetics to raise ketone levels to or above 3 mmol/L. From personal experience I would characterise venous pH below 7 as "severe" - my last (2nd only) DKA experience on admission my bicarbonate was 5 mmol/L and pH was 6.9 - when I later described to my sister (a medical professor in anaesthesiology) she freaked out and said that's effectively the death zone. Fortunately due to a fantastic A&E resusitation unit team (ICU had no free beds...) I was back to normal levels in about 18 hours. But don't want to be there again!
 
Ketones alone don't indicate DKA, they are just a flag for monitoring. As noted above, acidosis needs to be present and this will almost invariably mean hyperglycemia is also evident.
 
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