Ketones In Urine?

[AmandaAnne]

Hello all

My diabetes has been pretty out of control now for several months.

My GP did want to put me on an additional medication called Gliclazide at 80mg twice a day, this would be alongside my usual Metformin of 2000mg per day taken in 2 separate doses. However I am pretty frightened of this new tablet as I believe it can make you prone to hypos and they scare me! (I have already experienced one last year when I was dieting and hadn't eaten enough, my BG was 2.3 and I felt pretty awful)!

I managed to persuade my GP to give me 3 months to try and get it back under control using diet and exercise, sadly this doesn't seem to be working very well. My last HbA1c was 75 which was back in April of this year.

When I've been testing myself my BG is all over the show! I've been as high as 23, but also pretty good, I think, at 10.5 following eating beans on toast!

Anyway I have been hit with infection after infection mostly in the form of skin abscesses 2 of which have been pretty nasty, I also suffered a grade 2 skin ulcer on my buttocks! I have had 3 UTI's since the beginning of the year and repeated infections of thrush and all manner of skin problems.

Now twice in a couple of months, I have had fruity smelling urine, I had put this down to the infections, but I've got it again now but have no other UTI symptoms, only the fruity smell, so I did some research on this subject and it came up with possible Ketones in the urine and some condition or other, sorry can't remember the name?

I have been feeling pretty unwell for several months now with various symptoms, being nausea, very unsteady on my feet, disorientated, confused, brain fog big time! Thirsty all of the time, I permanently have a drink with me all day! dry mouth and although I drink life a fish, sometimes I'm hardly peeing!

Would any of you be able to give me a bit of insight into all of this please, I really know next to nothing about these Ketones and what I should be doing. Is it now time for me to start on these Gliclazide tablets? Are any of you also on these and if so, how are you getting on? Am I getting myself in a pickle over nothing with regards to these tablets?

Many thanks in advance.

 

[Indy51]

What weight reducing program are you following? It concerns me that you are still eating foods like baked beans on toast that are almost guaranteed to raise any Type 2's blood glucose levels.

Almost all the infections you describe can be worsened by high blood glucose, so getting your BG lower must be your first priority and you really need to see your doctor. Wounds can also be much harder to heal.

I'm tagging @daisy1 in case you have not read the advice to newcomers.

In your shoes, I would be looking at lowering your carbohydrate intake as a matter of urgency especially if you want to avoid further medication.

 

[Kavyaparmar]

Hi Amanda,

Have you been referred to a dietician who can help you carb count? I myself am a type 1 diabetic but the doctors had me on metformin, gliclazide and sitagliptin, my sugars were spiking and never came down below the 20's.

I suffered from two infections linked to my bladder and kidneys and it was HORRIBLE, I feel your pain..

It may be time to start the tablets, but also try speaking to a diabetic dietician they really do help

X

 

[daisy1]

@AmandaAnne

Hello and welcome to the forum

Here is the information Indy mentioned which is the advice we give to new members. I hope you will find it useful.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[AmandaAnne]

What weight reducing program are you following? It concerns me that you are still eating foods like baked beans on toast that are almost guaranteed to raise any Type 2's blood glucose levels.

Almost all the infections you describe can be worsened by high blood glucose, so getting your BG lower must be your first priority and you really need to see your doctor. Wounds can also be much harder to heal.

I'm tagging @daisy1 in case you have not read the advice to newcomers.

In your shoes, I would be looking at lowering your carbohydrate intake as a matter of urgency especially if you want to avoid further medication.

I'm not using any weight reducing program, I always fail on them. So I'm just trying to adjust to a healthy diet and I have been managing to loose weight doing what I'm doing, all be it very slowly.

I often eat baked beans, I have to keep a close eye on my iron levels and as they are very high in iron and lots of other good stuff, I do eat them regularly, normally about once a week and they don't seem to make my BG raise too much to be honest.

What makes this much more complicated for me is that I do have several chronic health conditions which all require me to do different things, so for me, it's a case of doing it the best I can really.

Thank you for your reply Indy51.

 

[AmandaAnne]

Hi Amanda,

Have you been referred to a dietician who can help you carb count? I myself am a type 1 diabetic but the doctors had me on metformin, gliclazide and sitagliptin, my sugars were spiking and never came down below the 20's.

I suffered from two infections linked to my bladder and kidneys and it was HORRIBLE, I feel your pain..

It may be time to start the tablets, but also try speaking to a diabetic dietician they really do help

X

Hi Kavyaparmar,

No I have never been referred to a dietitian, the advice I receive is from the diabetic clinic at my GP's surgery.

Yes the UTI's are just awful aren't they?! They always make me feel really unwell and uncomfortable too.

Thank you for your reply.

 

[AmandaAnne]

@AmandaAnne

Hello and welcome to the forum

Here is the information Indy mentioned which is the advice we give to new members. I hope you will find it useful.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

Hi daisy1,

Thank you for the information. I'm not really a new member though, I have been around for about a year, but I don't post that much so you probably haven't noticed me.

I know about the low carbing or no carbing diets, and the low carb, high fat one too.

Whilst I do my best to cut out some carbs, I do still have some in my diet, it makes me feel unwell if I don't have any and that was the very thing that lead me to having a hypo last year, because I hadn't eaten any carbs for 2 days and my BG dropped to 2.3.

It's pretty complicated for me really, I only wish it wasn't.

Thank you for your reply and information.