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Ketones and Type 2

R

rae_j

Member
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12
Anyone have any input on this question - any help would be really appreciated. I have drug induced Type 2 and was okay on diet and excercise having tried metformin but it didn't suit. My fasting blood sugar is under 7 although after eating it can get up to 13. I now have high levels of ketones after eating my evening meal. My Dr tells me that ketones should only be there if you are starving yourself and this is not the case as is shown by the steep rise in blood sugar levels. It apparently means that no glucose is being taken from the bloodstream and I either have to take diamicron at a very low dose or go straight onto insulin. Now for the but....the literature says that it is not safe and is contraindicated to take diamicron with high levels of ketones. 'hopefully it will be safe to take a low dose as you are not fully ketone acidotic' wasn't quite what I wanted to hear. I have been offered no reason why I have ketones after eating but Dr agrees that it needs sorting and quickly. I have an appointment with an endocrinologist but not for another 6 weeks. Has anyone else had this complication and can offer any advice. My GP is quite amenable to suggestions but I seem to be left a bit in the dark here and am resisting adding in yet another medication.
 
ketones can be present in people when they are eating either reduced or no carbs at all. it indicates that the body is burning fat, this state of 'ketosis' is not usually a problem for many people. (my opinion)

however if ketones are present and you have high blood sugar then this is a warning sign and can lead to DKA (diabetic keto acidosis) it is mainly in type 1's that this occurs to BUT can happen to t2's also. there is a similar condition called HONK (hyper osmolar non ketotic acidosis) that can affect t2's which is very similar.

both conditions can be very serious and you will need to keep your eye on your bg levels. i wont quote any levels because i keep getting told that mine are wrong, maybe someone here will be able to give you the 'correct' ones? :roll:

having read the manufacturer's prescribing info it does not recommend use in diabetic ketoacidosis which is a different from producing ketones (ketosis). your doctor hopefully will have consulted the prescribing information and based his decision on the information there. although it is his opinion which drug to take it is your decision whether you take it. just make sure you make an informed decision. i know i do :wink:
i hope that helps!
 
mcmoby69 said:
both conditions can be very serious and you will need to keep your eye on your bg levels. i wont quote any levels because i keep getting told that mine are wrong, maybe someone here will be able to give you the 'correct' ones? :roll:
Click to expand...

Well, we are always willing to oblige here......... We wouldn't want people to have the wrong information....would we :roll:

As a type 2 the NICE 2010 guideline Bg levels are as follows. I did give them you before when you asked, perhaps you need them posted again to refresh your memory ? You can always post them when advising members here. You could also post what you personally follow providing it is clear it is just your opinion and not what is the medically advised levels in the UK.

Fasting (waking).................between 4 - 7 mmol/l.
2 hrs after meals.................no more than 8.5 mmol/l.
Post meal readings which are lower are obviously better if you can achieve them.

Ken
 
sorry! my reply wasnt clear enough, the blood sugar levels i was referring to were when ketones were present. at what level should a diabetic with high BG's AND ketones present ,go to A&E?

i am aware of the NICE guidelines for recommended blood glucose levels.
they have been pointed out to me before. thanks but i dont think i will be quoting them on this forum or any other for that matter, i will leave that to the more knowledgable.

i do also realise that some people do not have the time or patience to study the new research that inevitably takes time to filter its way thru to the 'officials' who have our lives in their hands. until then we will have to be happy with the NHS and other 'official' sources reliably informing the majority of what is 'good' for them. i did notice the caveat this time, must have missed it previously
 
Here is a very good link to a WebMD article about this. Page 2 is very interesting in particular as it lists possible causes and also drugs which may affect readings:
http://diabetes.webmd.com/ketones-14241

Here is a link to this Forum's own Community Pages info about Diabetes and Ketones:
http://www.diabetes.co.uk/diabetes-and-ketones.html

Another one from Bayer:
http://www.bayerdiabetes.co.uk/sections ... d-Diabetes

To be honest, you say you are seeing your Endo in a few weeks, if that is so then that is the best place to ask questions and get answers. He/she is the expert and will know all about your medical history, drugs, lifestyle etc. All of this is relevant and I am certainly not qualified to give anything but an 'educated' guess as to what is going on.

There can be many reasons for the Ketones, not all of them straightforward.

Ken
 
Thanks for the info and the links. My 2 hour PP BS is around 13 but was told this didn't matter unless my fasting was consistently over 7 (which it isn't - runs between 6 and 6.8). The ketone level after eating is frequently at top end of the scale but normally mid to high range. As I am hours away from an A&E I am sure my GP would be the port of call but not knowing what the serious symptoms I would need to look out for in the first place I will just have to wait 6 weeks to see the endocrinologist. Opted against the diamicron for the moment.
 
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