Ketones when to worry.

[charlo98]

Hi. I had high bg 13.3 so checked my ketones last night they were +1 so left it as I remember being told +2. I’ve woken up and have +5 ketones but but bloods are only 7.9. This is fine right? As font injeeed high blood sugars too? Sorry I’ve just sort of been thrown stiff and told to get on with it (t2).

 

[charlo98]

Apologies for the typos. I’ve dropped my phone and can’t see part of my screen

 

[HSSS]

Dka is normally associated with high ketones and high blood glucose in the lack of insulin. So most usually type 1’s whether diagnosed or not (or even those misdiagnosed as type 2 initially).

Its not common in genuine type 2 as we mostly have an excess of insulin even if it doesn’t work particularly well. Being on medication like sglt’s (the flozins/jardiance) does increase the risk of dka with lower blood glucose levels a bit, more so if you also do a low carb diet alongside them (better to use different meds if you still need them on this way of eating).

A low carb/keto way of eating does cause ketones but these are intended and desirable and at much lower levels (usually 1-4 ish) than with dka (double figures and higher)

By what method are you testing ketones and are you low carb/keto? Do you feel in any way unwell?

 

[charlo98]

My doctor gave me ketones strips as she’s not 100% on type 2 (24, bmi 22, no family history and hba normal in august) to monitor it until I can see endocrinology. I’ll admit o went out yesterday lunch and had low sugars and where my friends took me I had no choice to eat carbs but also needed a boast (Eating out seems impossible). Yo my understanding to go into ketosis don’t you have ooo be carb free for a couple days? But then having ketones shouldn’t you sugars be up? Also worth mentioning I have a very bad cold, so I’m unsure what is that. Aches, thirsty, very tired ect

 

[HSSS]

Yes normally it takes a while to get into ketosis when on a low carb/keto diet. And when you first start it’s easy to be knocked out of it too. So unless you are consistently low carb and have been for a while you more likely are not in nutritional ketosis.

And no, nutritional ketosis does not mean high sugars. The lack of carbs causing ketosis would mean low/normal sugars.

Also colds, flu, rsv, covid and all the other nasty bugs (that on the face of it are quite similar without a test to be sure which it is) will all raise blood glucose in most of us. The immune system in everyone raises bgl to give us energy to fight invaders.

As your diagnosis is still uncertain, and I can definitely understand it’s nothing like a typical type 2 so type 1 really really needs excluding or confirming, keep an eye on both bgl and ketones and seek professional help (111 at least) if they both rise again together. Especially if you feel unwell in any way at all. Best to check than end up in very serious state because you were reluctant to ask.

 

[charlo98]

Yes normally it takes a while to get into ketosis when on a low carb/keto diet. And when you first start it’s easy to be knocked out of it too. So unless you are consistently low carb and have been for a while you more likely are not in nutritional ketosis.

And no, nutritional ketosis does not mean high sugars. The lack of carbs causing ketosis would mean low/normal sugars.

Also colds, flu, rsv, covid and all the other nasty bugs (that on the face of it are quite similar without a test to be sure which it is) will all raise blood glucose in most of us. The immune system in everyone raises bgl to give us energy to fight invaders.

As your diagnosis is still uncertain, and I can definitely understand it’s nothing like a typical type 2 so type 1 really really needs excluding or confirming, keep an eye on both bgl and ketones and seek professional help (111 at least) if they both rise again together. Especially if you feel unwell in any way at all. Best to check than end up in very serious state because you were reluctant to ask.

I’m on the phone to them now my glucose went to 15.6 and still +3 ketones but knowing 111 I won’t have a call back till tomorrow

 

[HSSS]

I’m on the phone to them now my glucose went to 15.6 and still +3 ketones but knowing 111 I won’t have a call back till tomorrow

Please, despite all the troubles with the nhs now, if you begin to feel at all unwell call back and if that doesn’t work urgently A&E. DKA is not to be messed with. Cut carbs out in the meantime (shouldn’t be hard for a matter of hours)

 

[EllieM]

I’m on the phone to them now my glucose went to 15.6 and still +3 ketones but knowing 111 I won’t have a call back till tomorrow

If what you have is DKA (and I'm not saying it is) then you may need tp go to A&E as you'll need insulin to treat the DKA.

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

The above article suggests you should go to A&E immediately if you think it's DKA

Are you alone or do you have someone with you?

 

[Ali_Type1]

Please speak to your diabetes team or nurse about your Ketones beacuse having them high is concerning with DKA , and drink lots and lots of water to flush out the ketones and try not to move much .

 

[Antje77]

I’m on the phone to them now my glucose went to 15.6 and still +3 ketones but knowing 111 I won’t have a call back till tomorrow

How are you now?

 

[Antje77]

Please speak to your diabetes team or nurse about your Ketones beacuse having them high is concerning with DKA

They tend to not be available during the weekend or on holidays.
A possible DKA is an acute thing, not something to wait out until after christmas when they are available again!

If ever you suspect DKA, act immediately, don't wait and see if it gets better over the weekend.