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Ketones in Urine

G

GD Mum

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5
Hi,

I am new to this forum and just wanted a little bit of advice. I was diagnosed with GD at 28 weeks and am now 33+4. It was a bit of a shock as even though my dad has type 2 I never really considered it. I felt really awful for a couple of days, full of guilt and shame but a friend advised that it was just my body asking me to watch what I ate more carefully, so I have been doing that. I am vegetarian and have been all my life, I am very diet aware and have always eaten lots of vegetables and healthy options. Since being diagnosed I have managed to control my sugars with diet alone and have not gone above 5.4 before eating or 7.0 1 hour after eating, and my fasting reading is normally 4.5. I thought I was doing well, even though I have been craving sugar like mad, and it has been hard to cut down on the carbs I really don't want to go onto medication so have been monitoring everything carefully.

Anyway, yesterday I saw the midwife and she mentioned that there are a small amount of ketones in my urine - which means I need to eat more!! She advised that I eat more carbs!!!! So - if I do this I run the risk of getting higher readings and potentially having to have medication. It is such a fine balancing act, and I feel a bit like I can't win. I just wondered if anyone had any advice at all? I have been ramping up my protein intake, and eating more tofu and pulses, but am wary about eating bread and not really sure what to do for the best? I have only gained 12 pounds my whole pregnancy, although my mum and sister where the same and put on most of their weight in the last few weeks, so I'm not really worried about that too much, I just want to make sure that I keep the diabetes under control.

Any advice on how to get the ketones stopped would be great

Thanks in advance

GD Mum
 
If you eat more than about 50g of carbs a day, there probably won't be any detectable ketones in your urine.

Having ketones in you urine is just an indication that you're burning fat instead of glucose. Many of us deliberately choose to be in that state, but obviously we're not pregnant. It's probably easier if you just eat a few more carbs (without going over the top).
 
Hi,

I feel very uncomfortable suggesting anything on this as I have absolutely no experience of the issues of ketones and gestational diabetes. So, as Borofergie suggests I would err on side of caution and slightly increase your carbs.

Here is a study I found on the levels of ketones in blood in GD (as opposed to in the urine) and it says that "For women with GDM, we are not currently in a position to conclude whether their ketonemia levels have clinical significance in terms of the pregnancy outcome or the health of the child."

Ketonemia just means ketones in the blood (and is really about how the ketones are measured rather than what they are doing).

It does however say something a bit alarming about research into ketones in the urine where it says that there is some evidence of "a negative correlation between ketonuria and intellectual quotient in children born to diabetic mothers has been reported (3,4). A relationship between high fasting ketonemia during the last trimester and delayed educational development has been suggested (5)."

http://care.diabetesjournals.org/conten ... 743.1.full

So, don't worry too much but up the carbs as your nurse suggested would be the prudent thing to do I think.

Best

Dillinger
 
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