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Ketones in urine

I

IanJGouGh

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My wife (T2) went for her first 3 month check with practice nurse. Was told she could have jam on her toast, brown rice and three biscuits daily. She was also told there were ketones in her urine. When she asked what does that mean she was told it can be to do with digestion and it wasn't serious but it has got her worried. Since diagnoses she has gone on LCHF and does fast walking every day and is losing weight. We bought a meter and her blood sugar levels are usually in the 4.3 - 6.0 range. I'm so proud of what's she done.
I've read on here about some health professionals not really understanding diabetes so can anyone tell me if these ketones are something to worry about?
Thanks
 
The ketones are what are seen when fat is being broken down, and in association with lower blood glucose they are perfectly normal and a good sign that everything is going in the right direction. They are excellent fuel too. The brain does particularly well when it has ketones for its energy needs.
I do wonder at the advice given - toast, jam, rice and biscuits are exactly what a type 2 diabetic should not eat, - it being a problem with dealing with carbohydrates. The usual advice given when such misinformation is being pushed is 'smile, nod, ignore' but we can only hope for better training in future.
 
The practice nurse is telling her what she can do, so as to do better them most people. It is clear we can do much better.....
 
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If you are doing LCHF properly you should have switched from being fuelled by carbohydrates to being fuelled by fats.
Ketones are a part of the fat burning cycle.
Any which are surplus to requirements can be expelled in the urine.
So if she is seeing ketones in her urine that looks like a very good thing!

The reason many are wary of ketones is that if your body isn't producing/processing insulin (so you have very high blood sugar but your body can't use it for energy) then your body goes into panic mode and burns muscle, which floods the bloodstream with ketones and makes it acid.

This is diabetic ketoacidosis which is very dangerous and is sometimes the reason for undiagnosed T1s and T2s to be rushed into A&E.

So a low to medium level of ketones in the blood is part of being fat adapted.

Very high ketones are not good.

Ketostix can be used to test the urine to confirm that you are kicking out the ketones, which can be an indication that you are fat adapted.
[Note: you can be producing and burning ketones and see none in your urine if you are burning as much as you are producing.]
 
@IanJGouGh, I don't think foodstuffs like biscuits and jam should be eaten regularly by a T2D. Although that does not rule them out entirely. 'Eat to your meter' is a phrase that's thrown about this forum regularly and quite frankly, is one of the most important aspects of diabetes management.

If I were your wife (how weird would that be!?) I'd request an appointment with a dietician. She is more than entitled to one.

As excellent a resource as DSN's are - a dietician will always know more about diet.
 
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Hi all Thi
Hi all. This thread I will keep an eye on as before Christmas I tried a low card diet and ended up in an ambulance on my way to A/E with high BG and ketoacidosis and contant need for the toilet.
Best of luck to all who can low carb but not for me.
 
@theoldfunker What meds were you on, and what went wrong? Do you make up your own low card diet or one it one of the published ones?
 

Care to give us a bit more detail about what you were eating?

Low carbohydrate is not expected to be worse for you than medium/high carbohydrate as long as you are eating more fat to keep the energy flowing.

Are you saying that eating low carbohydrate pushed your blood glucose out of control but eating more carbohydrates does not?
 
To the moderator who edited my post without providing a reason, would you kindly care to provide me with one?

I can be contacted via PM to avoid derailing the thread.

Cheers,
Grant
 
I test daily for ketones.
I am trying to lose weight by cutting carbs and calorie intake.
If I see small amounts if ketones I am reassured that my body is burning my fat reserves and hence hopefully getting my liver and pancreas to work better.
If on low carb. Small amounts of ketones is a good sign.
 
What is the benefit of testing for ketones? For example what action will result from you getting different test results?.
 
ringi said:
What is the benefit of testing for ketones? For example what action will result from you getting different test results?.
Click to expand...

It is an indication you may be in ketosis i.e. burning fats.
Mainly T2s on LCHF.
This in combination with normal BG.
If you don't get ketones you might eat less carbohydrate and exercise more.

Or in ketosis with your BG out of control and heading for trouble if it isn't fixed.
This is in combination with BG monitoring showing high BG.
Mainly for T1s and T2s on insulin.
If you get high BG and high ketones you consider A&E unless you can fix it quickly.
 
Followed a guide on DIET DOCTOR found a link on the forum but maybe tried to hard to cut carbs. Couldn't test for ketones but BG was 22 and passing water every 10 - 15 min thought it might be a good idea to take myself of to the walk in centre were they retested and told me it was 30 mmol check my heart as it was racing then called the ambulance. Later in A/E I seemed to wake from a strange dream, it seems I flipped out.
 
I can understand why those shocked by a diagnosis of diabetes change their diet rapidly to bring down an hba1c, but sometimes our bodies are thrown out of equilibrium by changing diets rapidly and it would be more prudent to change the ratios of carbs, fats, protein and their sources more gradually. It probably took a very long time to get T2D , let's be balanced and work at as best we can, rather than condemning an approach because we went at it , "like a bull at a gate!" and it went base over apex! I have found in life the extremes are very similar, its balance thats hard to achieve! Then again, I am an old man! Derek
 
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@theoldfunker

I expect your out of control BG had nothing to do with going "low curb" and that your body had just had enough and went on strike.

Given your experiences, I think you should try reducing curbs by a bit each week, starting the the curbs that have the highest GI testing the BG and carefully controlling any meds. Just avoiding all added sugar and cooking all your own food goes a long way, then think about how to cut down on things that contain wheat.

Even if it take over a year to control your curbs (and hence BG) its OK providing you are moving slowly in the correct direction. (The meds gives you "breathing space" and lets your body rest, so they are not an issue in the short term.)
 
I know someone on the early Atkins Diet#1 who had similar experience to yours, His problem was twofold. Firstly he was consuming alcohol in a big way on what was effectively an empty stomach, and secondly he overdid the protein input. Now protein gets converted to blood glucose, just like carbs, but at a slower rate. So a protein intake greater than 1 gram per 1kg body weight can cause complications unless body building or HIT training. I personally had a faggot too many last night, and it pushed me up by 4 mmol/l so it is possible to overdose on protein.

Two years ago my bgl readings were above what my meter could register, then since LCHF I rarely go higher than 10 mmol/l after a meal (generally a chinese takeaway). You have not indicated any medication, so it may be you expected more immediate reaction to LC diet than it gave, and maybe the high bgl readings are still due to the previous way of eating rather than what I would normally expect from an LC intake, It took me a month or so to regularly drop my bgl when I started out down the LC path,

The maxim we use and the mantra we quote is 'Eat to Meter' since it only needs one ingredient to upset the apple cart and it takes time to gain the knowledge of what foods are safe, and which spike us. We are all different so i can eat things that many here cannot, and vice versa.
 
Thank you for that. Not sure if I want to give it another chance yet, got to read more before I give it another try.
Alcohol has long been of the list as it was recommended by the doc as it can reduce the effect of metformin. I can't remember if I was eating nuts as part of a low carb but I take note of that fact as I didn't know that and thought it was on the protein list.
 
Hi yes I have only just become aware about wheat sugar that's used as artificial sweetner. I need alot more information before I go full out again on low carb. My metformin has been adjusted to 2 a day as I do behave with a sensible diet so I may not take a pill if my dinner is fish which I know has no effect on my BG level and I won't be above 6mmol.
 
I agree with what you say as it was after my second 90 day check up and told that the overall BG WAS 12 so I felt I need to do better but may have tried too hard and the impact has to quick.
 
Good approach there.

I did a load of research into the diet and the science behind it, and then went fairly gently into it, I was very sceptical at first, but gradually found the research papers and presentations that convinced me it worked and was safe for my condition and meds. It is important you develop an understanding of the relationship between carbs, protein, and fat and how these individually work on our metabolism and blood transport systems (endocrine system). The LC threads on here have this info but it needs a bit of study to get a clear picture of how things work out in relation to the weekly shopping.

I have been doing LCHF for 2 years now, and my whole family has joined me on it and we are happy with it even now. I am lucky in that I was able to dramatically reduce my meds and HbA1c to low levels without having to be too strict about it. It is only now, while I come off the last of my meds that I am having to become stricter on my intake. I have gone from being on the verge of insulin therapy as a last resort, and on a heavy dose of oral meds down to popping just a couple of pills a day now. And my bgl is still in control. All thanks to this site and the people here.
 
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