Hi was wondering if anyone can help i have just came out of hospital after having dka i know that keytones occur when blood sugar level is to high but can you get them if its to low??
Ketones + diabetic ketoacidosis (DKA)
- Thread starter charlie229
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Re: keytones
Hi Charlie,
Ketones build up in the body when the body burns fat to create energy to fuel the body.
DKA happens mostly in those with type 1 diabetes when not enough insulin is present. This results in high glucose as there isn't enough insulin to enable the body to utilise the glucose. The result is that the body results to burning fat instead which causes an overload of ketones in the body, if the levels are too high this becomes acidic in the blood stream and potentially very dangerous and sometimes life threatening.
If your blood glucose is low this indicates there is enough insulin to control blood glucose levels so there will be no need for the body to burn fat for energy so no ketones will be made.
If you recently had DKA it could be that your body is still getting rid of the ketones but recent insulin has regulated your blood sugar levels, it is possible to have ketones and a low blood glucose reading.
Aslong as you keep your blood glucose within range as often as you can, the ketones should disappear as the body flushes them out with urine,saliva and sweat.
If you are concerned that ketones are still present and your blood glucose is returning to high levels it would be wise to seek medical advice as you recently had DKA.
Hope this explains things for you, ask if your unsure about anything at all
Hi Charlie,
Ketones build up in the body when the body burns fat to create energy to fuel the body.
DKA happens mostly in those with type 1 diabetes when not enough insulin is present. This results in high glucose as there isn't enough insulin to enable the body to utilise the glucose. The result is that the body results to burning fat instead which causes an overload of ketones in the body, if the levels are too high this becomes acidic in the blood stream and potentially very dangerous and sometimes life threatening.
If your blood glucose is low this indicates there is enough insulin to control blood glucose levels so there will be no need for the body to burn fat for energy so no ketones will be made.
If you recently had DKA it could be that your body is still getting rid of the ketones but recent insulin has regulated your blood sugar levels, it is possible to have ketones and a low blood glucose reading.
Aslong as you keep your blood glucose within range as often as you can, the ketones should disappear as the body flushes them out with urine,saliva and sweat.
If you are concerned that ketones are still present and your blood glucose is returning to high levels it would be wise to seek medical advice as you recently had DKA.
Hope this explains things for you, ask if your unsure about anything at all
Re: keytones
Ketones are also produced if you are eating a very low carb diet (usually under about 50g of carb per day). This is because you are burning fat instead of glucose from carbs.
As long as your blood glucose levels are in the target range for your type this is no problem, as the ketones get flushed out of the system quite normally, in the ways Ebony describes. They show when you test your urine, but there is no need to worry about them as long as your blood glucose levels are not high.
Viv 8)
Ketones are also produced if you are eating a very low carb diet (usually under about 50g of carb per day). This is because you are burning fat instead of glucose from carbs.
As long as your blood glucose levels are in the target range for your type this is no problem, as the ketones get flushed out of the system quite normally, in the ways Ebony describes. They show when you test your urine, but there is no need to worry about them as long as your blood glucose levels are not high.
Viv 8)
Re: keytones
I have had my son with perfectly good blood sugar and blood ketones of 3.4 and going into DKA (thirsty mainly). He had been quite ill for a few days before and not eaten very much so was burning fat for energy as he didn't have access to glucose. In a person with Type 1 diabetes DKA can be very dangerous. Even with low blood sugar high ketone levels need to be dealt with.
viviennem said:
I have had my son with perfectly good blood sugar and blood ketones of 3.4 and going into DKA (thirsty mainly). He had been quite ill for a few days before and not eaten very much so was burning fat for energy as he didn't have access to glucose. In a person with Type 1 diabetes DKA can be very dangerous. Even with low blood sugar high ketone levels need to be dealt with.
"Even with low blood sugar high ketone levels need to be dealt with"
Eeep! I'm a bit confused by this posting....when I was diagnosed around a year and a half ago I had DKA (all the usual signs: losing weight like nobodies business, breathlessness, shattered all the time, really bad heartburn etc) my BM was 22 when I was diagnosed.
Anyway, shoot forward a year and a half, and after having fairly poor control trying to use DAFNE principles (haven't been able to do course, jst trying to carb count and adjust) I stumbled over this forum and decided to give low carb a try. 4 days in and I am amazed. Practically every reading is within target range. Have gone low a few times (only mild around 3.5-3.8) but I reckon adjusting my basal overnight will tackle this.
So! After that preamble, my point. Feeling fab and with great BMs I tested for ketones last night (I've been eating under 50g of carb on this new plan) and they showed 'strong'....I thought ketosis with normal BMs was completely natural process??? How could your son have DKA and his reads were okay?? So confused. Am bit worried now! Could somebody clarify?? Have also experienced feeling quite cold, and also a wee bit heartburny on this low carb plan....but I was putting that down to the change in diet....have also read other postings of ppl having these symptoms.
Answers would be greatfully appreciated!
Cheers folks
Steph xxxx
Eeep! I'm a bit confused by this posting....when I was diagnosed around a year and a half ago I had DKA (all the usual signs: losing weight like nobodies business, breathlessness, shattered all the time, really bad heartburn etc) my BM was 22 when I was diagnosed.
Anyway, shoot forward a year and a half, and after having fairly poor control trying to use DAFNE principles (haven't been able to do course, jst trying to carb count and adjust) I stumbled over this forum and decided to give low carb a try. 4 days in and I am amazed. Practically every reading is within target range. Have gone low a few times (only mild around 3.5-3.8) but I reckon adjusting my basal overnight will tackle this.
So! After that preamble, my point. Feeling fab and with great BMs I tested for ketones last night (I've been eating under 50g of carb on this new plan) and they showed 'strong'....I thought ketosis with normal BMs was completely natural process??? How could your son have DKA and his reads were okay?? So confused. Am bit worried now! Could somebody clarify?? Have also experienced feeling quite cold, and also a wee bit heartburny on this low carb plan....but I was putting that down to the change in diet....have also read other postings of ppl having these symptoms.
Answers would be greatfully appreciated!
Cheers folks
Steph xxxx
Dillinger
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I don't know about Khaleb's situation, but normally if you are low carbing and have sufficient insulin then ketones are ok as they just mean your are burning fat.
In addition to Jen I remember some other people have reported that DKA rather than ketosis had occurred with insulin present, but that must be rare and/or something else must be going on.
Just keep an eye on the ketones, on a low carb diet the ketones I have are normally at the low or at most medium levels.
Obviously, if there are other factors such as illness or other underlying health conditions then you need to be extra careful. There are quite a lot of posts about the difference between ketosis (hurrah) and ketoacidosis (boo hiss) on the forum.
Best
Dillinger
In addition to Jen I remember some other people have reported that DKA rather than ketosis had occurred with insulin present, but that must be rare and/or something else must be going on.
Just keep an eye on the ketones, on a low carb diet the ketones I have are normally at the low or at most medium levels.
Obviously, if there are other factors such as illness or other underlying health conditions then you need to be extra careful. There are quite a lot of posts about the difference between ketosis (hurrah) and ketoacidosis (boo hiss) on the forum.
Best
Dillinger
phoenix
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Ketones develop very quickly in children, less so in adults but even so they need to be watched.
Ketones are normally surpressed by insulin, if they start to rise in a non T1 insulin will normally be released, this acts like a brake ,it stops the the breakdown of fats and the production of ketones. This isn't the case in T1, if insulin levels aren't high enough the breakdown of fat and production of ketones can continue. The most usual scenario for low blood glucose levels and higher ketones is when a person has been vomitting DKA is not common at normal levels but it is possible(more so in children and in pregnancy)
this case study describes a young woman with DKA and a bg level on admission of 3.9mmol, she had been through a week of 'cold-like symptoms followed by 24 hours of vomiting'
http://onlinelibrary.wiley.com/doi/10.1 ... .1220/full
In a chart In the Ragnar Hanas book he says that if glucose levels are less 10mmol and blood ketones are below 1.5mmol, to eat something containing carbs. If they are between 1.5mmol and 2.9mmol/l to eat something and then take insulin when glucose levels rise.
If they 3.mmol or above to seek medical advice. 'Starvation' ketones are however usually below 3.0mmol/l . This would equate to at least large ketones on urine strips. (some say 1.5-3mmol/l for large so a bit ambiguous)
Ketones are normally surpressed by insulin, if they start to rise in a non T1 insulin will normally be released, this acts like a brake ,it stops the the breakdown of fats and the production of ketones. This isn't the case in T1, if insulin levels aren't high enough the breakdown of fat and production of ketones can continue. The most usual scenario for low blood glucose levels and higher ketones is when a person has been vomitting DKA is not common at normal levels but it is possible(more so in children and in pregnancy)
this case study describes a young woman with DKA and a bg level on admission of 3.9mmol, she had been through a week of 'cold-like symptoms followed by 24 hours of vomiting'
http://onlinelibrary.wiley.com/doi/10.1 ... .1220/full
In a chart In the Ragnar Hanas book he says that if glucose levels are less 10mmol and blood ketones are below 1.5mmol, to eat something containing carbs. If they are between 1.5mmol and 2.9mmol/l to eat something and then take insulin when glucose levels rise.
If they 3.mmol or above to seek medical advice. 'Starvation' ketones are however usually below 3.0mmol/l . This would equate to at least large ketones on urine strips. (some say 1.5-3mmol/l for large so a bit ambiguous)
borofergie
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Wouldn't it be worth stickying this somehow? It seems to come up often, and Phoenix's explanation is the best that I've heard...
I should have also written in my post that Khaleb did have some high levels in the days before and the ketones levels had been going up and down for the days he was sick. Yes, it was an illness that involved vomiting. I also believe that ketones are produced far more quickly and become problematic in children compared to adults.
My question is that I am of the understanding that ketones are damaging to kidneys (over many years) so if you are living with ketones all the time are you doing damage? I would think the average person who is T2 would have very low levels of ketones even if they low carbed.
Are other organs of the body affected by higher levels of acid in the blood and do people who have moderate to high levels of ketones not think this is a problem or that having low blood sugar is cutting down any other risk factors?
My question is that I am of the understanding that ketones are damaging to kidneys (over many years) so if you are living with ketones all the time are you doing damage? I would think the average person who is T2 would have very low levels of ketones even if they low carbed.
Are other organs of the body affected by higher levels of acid in the blood and do people who have moderate to high levels of ketones not think this is a problem or that having low blood sugar is cutting down any other risk factors?
When i was looking for information on DKA i looked on some of the manufacturers websites, they have some information on there to
I've been Diabetic since April 2000, started off with excelent control then fell into the "can't be bothered/denial" stage after 3 years, this caused my control to go wildly off at a tangent. In October 2004 I was admitted to Bangor Hospital, North Wales with later stage DKA, barely conscious and with a BG reading of 42.5 my Ketone levels were far higher than the hospital had previously seen witha blood PH of 2. I was in so much pain that the Doctors had to give me a morphine shot before they could get a canula into me to begin sliding scale insulin. I was also on gas and air as my lungs were damaged from the dstrain they'd been put under as I vomited every half hour for 48 hours straight. I was told, once I was aware enough, that I had been only half an hour away from dying, that made me sdit up and take stock. My BG readings now mostly remain where they should, though I do go high when unwell, but take my Insulin accordingly, that said I have had starvation Ketoacidosis before, only the bacterial markers gave away that it was from an infection as my BG had (and does) gone higher than my meter can read (36.5mmol/L) I have gone DKA 7 times mostly due to infections (I have a weakened immune system) and have been admitted to hospital each time for no less than a week each time.
Last year I had an infection within my brain, causing me to have to leave work after just one hour and get rushed to hospital with a high fever (42 celcius) and rash. Ketone levels were just starting to rise but were not too high, I got there in time, though I was vomiting heavily and losing consciousness a lot.
Anyway getting back on topic, Ketones are caused by two factors, one is too little insulin in the body to turn free glucose into an adequate source of energy, thus fat molecules are broken down with Ketones being one of the nastier by products. The other cause of Ketone is too little free glucose in the blood which also makes the fat deposits get broken down. I've hads both types and they are equally as nasty as each other. If you have a BG meter that can measure Ketones (Optium Exceed or Glucomen XL Plus) then it is a good Idea to have a pack of beta ketone strips handy as blood ketone levels are more accurate than urine ketone levels (which is a measure of anything up to two hours ago) If Blood Ketones exceed 1.8mmol/L then you need Medical assistance anything lower can be self treated if you know what you are doing, if not get help.
BTW Ketones can be reduced by a slight increase in potassium (i.e. eating a banana or two, this helps to normalise blood PH and neutralise the ketones themsleves.
Cheers,
Dale Williams
(How about that for a first post on these boards then?)
Last year I had an infection within my brain, causing me to have to leave work after just one hour and get rushed to hospital with a high fever (42 celcius) and rash. Ketone levels were just starting to rise but were not too high, I got there in time, though I was vomiting heavily and losing consciousness a lot.
Anyway getting back on topic, Ketones are caused by two factors, one is too little insulin in the body to turn free glucose into an adequate source of energy, thus fat molecules are broken down with Ketones being one of the nastier by products. The other cause of Ketone is too little free glucose in the blood which also makes the fat deposits get broken down. I've hads both types and they are equally as nasty as each other. If you have a BG meter that can measure Ketones (Optium Exceed or Glucomen XL Plus) then it is a good Idea to have a pack of beta ketone strips handy as blood ketone levels are more accurate than urine ketone levels (which is a measure of anything up to two hours ago) If Blood Ketones exceed 1.8mmol/L then you need Medical assistance anything lower can be self treated if you know what you are doing, if not get help.
BTW Ketones can be reduced by a slight increase in potassium (i.e. eating a banana or two, this helps to normalise blood PH and neutralise the ketones themsleves.
Cheers,
Dale Williams
(How about that for a first post on these boards then?)
Hey Dale welcome
Blimey I bet your finger tips ache now Lad :lol: You have been through some really rough times I feel sorry for you but glad you are getting good control for the majority of the time.
I think we all go through that " oh just forget it,can't be stressed" with it stage .In the early days I did, and even later days from time to time when other things have had to take priority. It brings it home to me though how important it is to have good control and not do that when I hear a story like yours.
Good luck for the future mate
Blimey I bet your finger tips ache now Lad :lol: You have been through some really rough times I feel sorry for you but glad you are getting good control for the majority of the time.
I think we all go through that " oh just forget it,can't be stressed" with it stage .In the early days I did, and even later days from time to time when other things have had to take priority. It brings it home to me though how important it is to have good control and not do that when I hear a story like yours.
Good luck for the future mate
Yes, what a post, Dale (and welcome). I think many people underestimate ketones and DKA and all the medical staff I speak to tell me the correct amount of ketones in the blood is zero. I know many on here don't agree but maybe time hasn't passed enough to get the end result of having ketones more often than not. All the best with your continued monitoring of a relentless condition. As a parent I can't say I've even given up or couldn't be bothered - that's just mum's for you though!
From December last year I was misdiagnosed by my doctor and told I was not diabetic, when I pointed out the sores on my legs I was told that I was allergic to the shower gel I was using. Then in March of this year when on holiday some 200 miles away from home I started feeling ill and went to see the local doctor, I went early in the morning as I thought a fasting blood test might be required. I was phoned that night and told I had a blood sugar reading of 27.5mmol and to start on tablets straight away. After 3 days I felt even worse and opted to go home. On arriving at home I was violently sick and was taken to see the out of hours doctor at the hospital. She didn't know how to use the little machine that tests blood sugar levels and sent me home. Early the next morning my husband called 999 and got an ambulance. I was semi-conscious, I was bundled into the ambulance and on the way to hospital a drip was put into my arm. Three days later I woke up to find myself attached to three drips. I had gone into a diabetic coma with KDA and was very near death. I had T1 diabetes not T2 as was suspected because of my age. When I went to see my own GP she said she would understand if I was a little upset by being misdiagnosed since December. I thought a little upset? And had it out with her. We now get on very well, but I don't let her treat me for my diabetes, I leave that up to my nurse who is fantastic.
