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Ketones, do I have to worry right now?

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1
So, I am nauseous and I can taste and smell that weird sweet fruity flavour in my breath.
I know I have ketones. I don't have tests at home, but I recognize it.

First, I have been diagnosed with Diabetes type 1 as well as EDNOS w/ bulimic and anorexic tendencies.

The past few days I have not been eating enough, and I have been working out quite a lot. My blood sugar levels have been okay until yesterday. Yesterday night I had a bad binge. My blood glucose ended op at 30 mmol/l. I didn't really inject insulin because I was afraid of weight gain (I have struggled with diabulimia and this was a bit of a relapse).

At four I woke up feeling really awful. I was at 22 mmol/l. I injected quite a bit of insulin, and woke up a while later with 16 mmol/l. I felt really bad about my binge, so I couldn't bring myself to really eat a meal. Instead I had some blueberries and two hours later my blood sugar was at 2.7 mmol/l. So I had some dextro energy tablets and ended up at 5.0 mmol/l. It should be okay now, but I still feel nauseous and I can still taste it in my breathe. I feel really ill. But my blood sugar levels are not high any more... Do I have anything to worry about? Are the ketones gone? I'm not sure. I can't really bring myself to eat right now. Do I really have to? Or can I wait until my blood sugar drops again? Will I gain weight from my binge yesterday?

Things that might be important:
1. I have been very stressed lately so my stress hormones are high.
2. I have been on a high carb low fat/protein vegan diet for about two weeks, mostly fruits and seeds, not much starch. My carb and calorie intake were higher because of it, but I didn't need more insulin to manage my blood glucose at all. If anything I just needed even more carbs.
3. I have lost about seven pounds in the past week or two weeks or so. I'm not sure how. I have not been eating much in the past few days (except for the binge) but I was eating fine (many fruits, vegetables, seeds, sugars and some fats, starch and protein) so if anything I should have been gaining weight.

What should I do? Is there anything I need to worry about right now? Should I tell someone? Will the ketones go away? Should I test them somehow? Should I go home for now (no one is home and I am at school right now)? Do I really need to eat?

Thank you. <3
 
My advice would be to go to the school office, if you can't tell them what's wrong show them this post they will get you to the most relevant person.
Please don't feel embarressed or ashamed we all need a bit of help sometimes. Take care and let us know how your doing.

Sent from the Diabetes Forum App
 
If you are using a ketogenic diet below 50 carbs a day for most - ketones are normal and safe. Up to 3 mmol is considered optimal. However if you are running high ketones and high blood glucose numbers this can be highly dangerous and requires quick attention from your Doctor or diabetes experts.

" I didn't really inject insulin because I was afraid of weight" This is not a safe thing to do, safe blood glucose numbers must be your priority, don't take risks and end up in A and E.

FB
 
Re: Ketones, do I have to worry right no

I really would feel better if you could go see your doctor (t1 feeling ill with high BG and suspected ketones is an emergency and you will be seen quickly) but I'm guessing that you are posting here because you are not going to do that.

I think it really would be best if you could test for ketones because the events you describe don't make much sense, leaving me to question whether you can accurately tell that you have ketones - if your BG levels are normally OK then you would not expect a carb binge to result in ketones: ketones are released when cells are starving because they can't use the preferred fuel, glucose, for energy (either in people who eat very little carbs or diabetics who don't have insulin cells need to utilise the glucose in the bloodstream); in response to that the body dumps more glucose in the bloodstream (because cells are reporting that there isn't any) and you get DKA with sky-high blood glucose *regardless* of what you eat.

When you binge on carbs it's a different: there is enough insulin for cells to use glucose but not enough insulin to move all the glucose into storage, resulting in high BG. Whilst less immediately fatal this still causes damage to blood vessels ultimately leading to the classical diabetic complications. Since your BG is normally OK and was OK the morning after I think that this is the case (I.e. I think you are wrong about having ketones)


you should have been told by your doctor, and he'd be the person to see but if you are not happy to do that then you should be able to ketone test strips or ketostixs at a pharmacy without prescription. They are needed for exactly this kind of situation - to tell if high BG reading is due to a carb binge (not an emergency) or absolute insulin deficit (emergency)
 
Hi,

I'm type 2 and have just had surgery after my operation I was really ill and my ketones reading Was 13.3. I was just been sick all the time for the next few hours and the doctors had to give something to stop the sickness , is this normal and do I need to now monitor my ketones on a daily basis?
 
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