Ketones with normal blood sugars

[megan]

I recently got the flu and was feeling awful with a temperature and all the fun that comes with it!. I knew I had to keep eating and taking in fluids though. I could barely get out of bed but I did what I had to. On the 3rd day in the night I checked and found I had high levels of ketones in my urine but in my blood it was 0.9. I checked again a little while later and it was 1.1 in my blood. Then 1.4. My sugars weren't too bad. As the ketones were rising and it was getting later I was worried at what point I would need help. The rule of thumb being getting advice at 1.5 and above and if higher and vomiting then going to A & E.
I rang 111 as I didn't have anywhere else I could ring at that time. Then a paramedic phoned back to chat. She felt a dr was needed. A dr came round and said Id done the right thing. He found I had a UTI so prescribed antibiotics straight away.
I was in a state but he said the ketones didn't concern him at this point particularly as they'd come down a bit since he arrived. Down to 1.1.
He was very kind.
I have since been in touch with my diabetic nurse during work hours and we have an appointment soon. She told me to check my pump Manual for sick days. I did and can't find any mention of ketones with normal blood sugars.
She told me the treatment is the same. Go to hospital, get put on a glucose drip and double the insulin.
We are 3 weeks on and I still have the tail end if this horrible flu virus thing. I live with ME and fibromyalgia too.
I would rather avoid hospital at all costs. Last time I went in years ago for unrelated reasons I had to get my own blankets and meds back to deal with myself. I prefer to feel in some semblance of control in my own home than relying on others.
What I'd like to know is others experiences and knowledge. Thanks

 

[ME_Valentijn]

My sugars weren't too bad.

What's not too bad? Hyperglycemia can result in excess ketone production starting at 13.3.

There can be a fairly big delay between hyperglycemia and urine ketones ... maybe there's a similar delay with blood ketones? I had an 18.5 spike during the afternoon while at the GP's office with only "small" amounts of ketones in my urine, but measured "large" amounts of ketones in the evening when my blood sugar was already down to 10-11.

Maybe you missed a spike in your blood sugar, but caught the after-effects in your ketones?

We are 3 weeks on and I still have the tail end if this horrible flu virus thing. I live with ME and fibromyalgia too.
I would rather avoid hospital at all costs. Last time I went in years ago for unrelated reasons I had to get my own blankets and meds back to deal with myself. I prefer to feel in some semblance of control in my own home than relying on others.

I have ME/CFS too, and totally understand where you're coming from. I stayed home with a likely case of lactic acidosis induced by metformin, because I felt way too sick to deal with calling anyone or going anywhere, much less a hospital. Probably wasn't thinking too clearly either, due to the severe acid-frying-my-brain headache that came with it But the noise, the lights, the food, uncomfortable beds ... it would be torture.

 

[megan]

My bloods were between 5 and 11... got to 13 at one point but I also didn't want to go hypo when I was sick at one point. I got very shaky and weak and hot.... I always got told that blood ketone testing was what was going on currently so more correct where as urine test was hours behind .
There doesn't seem to be much information about this

 

[megan]

Can this post be moved to the type 1 diabetes discussion for others to see as it's not just about the pump? Thanks

 

[catapillar]

If you had ketones but normal blood sugars when you were ill and hadn't eaten it's likely you had starvation ketones.

But with blood sugar getting up to 13 it could have need ketones related to high blood sugar and the illness.

As your DSN has said, either way when your ill just follow the sick day rules. If you think it could be starvation ketones try to take it something light and bolus for it and see if that gets rid of ketones.

Sick day rules do give good guidence on caring for yourself at home. But there's a lot of testing every two hours and if you are sick that might not be something you are up to. If you go to hospital because you need help it might be that you get discharged pretty quickly, maybe quicker than if you push yourself to stay at home and delay recovery.

http://www.mydiabetesmyway.scot.nhs.uk/resources/leaflets/SickDayRulesForType1.asp

 

[megan]

Thank you. I was struggling to eat as my throats was so painful as well. But the first two days I was able to have some ice pops strangely, to help as my sugars kept dropping too, which never normally happens. I'm normally quite resistant to my meds. So I had quite good bloods mainly. I think perhaps the less food was the issue here as it wasn't normal main meals. Also I had been doing a low carb regime for the previous month, to try to get better blood sugars and lose some weight. It's a futile process I've done many times over the years that doesn't improve my bloods or my weight. My gp was more concerned it would add to my fatigue. Since being ill I have eaten more and got better bloods and feel stronger than I did, well as well as I can with chronic fatigue .... onwards and upwards