Ketones high for a few days - advice needed

[cbooth5]

Newly diagnosed June this year type one diabetes. Been doing really well on the whole, usually 70-80% in range nowadays, so thought I'd have a snack Friday night. Usually I don't inject for snacks as still early on in honeymoon phase. I'd estimate I probably ate 30-40g carbs (30g crackers , 10-20g balti mix) - chose balti mix as this usually doesn't seem to spike BMs much

Woke up the next morning a bit horrified as I had my high BM alarm turned off and had been running at ~13 all night, at one point it had reached 15 and 18!! Ketones 0.6 Saturday morning... drank loads of water, tried to keep BMs down and drank more water and it ent to 0.5 0.4... tested again now and it's still 0.6. The protocol says check again in few hrs and drink water.. don't feel too bad just tired, felt dazed Sat morning. Any advice for getting the ketones down to 0.1/0.2 please. Or will it just take a few more days? Thanks in advance, keeping a look out for DKA symptoms too.

 

[Antje77]

What have you been eating today?
If you've had very little carbs this could explain the level of ketones.
As far as I know, ketones as low as you see them now (0.4 0.5 0.6) aren't alarming, especially if your BG has gone back to reasonable numbers.

So how have your BG levels been today?

Usually I don't inject for snacks as still early on in honeymoon phase. I'd estimate I probably ate 30-40g carbs

How do you normally decide on doses for meals? Do you have an insulin to carbs ratio or are you on fixed doses?

 

[cbooth5]

Thanks for the message. Today there was a bit of social pressure as we ate out with family, had a roast dinner (tricky to dose) so BMs went up to 14 after that.

But on the whole control has been good last two days otherwise. I tend to use a 30g carbs:1 unit ratio which works best. Yeah I've tried to get carbs into my diet today and definitely ate enough/had enough insulin so hopefully they drop tomorrow, good to know they aren't alarming or anything thanks! I'm often low if anything so it's my first time running high overnight think I'm fine just overreacted at first.

 

[cbooth5]

What have you been eating today?
If you've had very little carbs this could explain the level of ketones.
As far as I know, ketones as low as you see them now (0.4 0.5 0.6) aren't alarming, especially if your BG has gone back to reasonable numbers.

So how have your BG levels been today?

How do you normally decide on doses for meals? Do you have an insulin to carbs ratio or are you on fixed doses?

I known usually people inject for snacks etc. But I was advised not to and that was about a month ago. Might ask my nurse now though as things have changed a lot and need insulin quite a bit more now! Maybe I should implement the ratio for snacks too

 

[Antje77]

I known usually people inject for snacks etc. But I was advised not to and that was about a month ago. Might ask my nurse now though as things have changed a lot and need insulin quite a bit more now! Maybe I should implement the ratio for snacks too

Your body has no idea if what you eat is a 'meal' or a 'snack', and carbs don't behave differently if you call them a snack or a meal.
That said, with a ratio of 30 grams of carbs to 1 unit, there are a lot of snacks you won't need insulin for (very different from my own ratio).

Do you use a half unit pen? If you need so little insulin, I really think you need one, or a pump, which can dose even smaller amounts.

 

[cbooth5]

Thanks for the advice! Really reassuring, maybe I wasn't aware of how much I actually ate maybe.. as I try to stick to one snack only usually. Very lucky I managed to get hold of a half unit pen last month and has been a lifesaver for meals which fall 'in the middle'

So many other factors play a part though as you know; exercise, tiredness, business, when last ate, sensitivity day to day etc!

 

[Antje77]

maybe I wasn't aware of how much I actually ate maybe.. as I try to stick to one snack only usually.

Matching insulin to food is not about how much you eat, or about how many snacks you eat.
It's just about how many carbs you eat. So a high carb snack like you had needs insulin, but a low or no carb snack doesn't.
Even if you eat 5 large snacks of cheese or salami, it's unlikely you'll need insulin for it.