Ketones

[bonkers82]

@bonkers82
A word of caution. (This already referenced by @ziggy_w )
Diabetic ketoacidosis is normally diagnosed by a combination of high ketones and high blood glucose.
However if you are on medication that causes you to pee out sugar this can reduce your blood glucose readings when you are actually in ketoacidosis. Jardinace is a drug which causes you to pee out sugar.

So for someone who is on Jardinace and is showing rising ketones then A&E is probably a sensible move because DKA or EKA can develop very quickly and is dangerous if not treated promptly.

The ketone levels that you are showing are not considered dangerous for a T2 but are "blues and twos" for a T1.

As a rough guide up to 5 on the ketone scale is fine if you are on a keto diet. I've been up in the 4s whilst fasting.

However, for a T1 or an insulin dependant T2 it is different.
https://www.diabetes.co.uk/diabetes_care/testing-for-ketones.html
"
WHAT SHOULD THE KETONE TEST RESULTS BE?

• Under 0.6 mmol/L – a normal blood ketone value
• 0.6 to 1.5 mmol/L – indicates that more ketones are being produced than normal, test again later to see if the value has lowered
• 1.6 to 3.0 mmol/L – a high level of ketones and could present a risk of ketoacidosis. It is advisable to contact your healthcare team for advice.
• Above 3.0 mmol/L – a dangerous level of ketones which will require immediate medical care.

"
Your reading of 3.2 is up in the danger area by that guidance.

So if, and this is a big if, you aren't producing enough insulin to control your BG and this is being masked by the Jardinace flushing glucose out of your bloodstream then you could be showing symptoms of EKA. That is, your body isn't managing to get glucose into the tissues for energy and so is breaking down fat (and possibly muscle) for energy.

We can't diagnose, obviously, but it might be worth asking your GP if you can have your insulin levels checked because it seems that if you are producing adequate insulin then you aren't at risk from those ketone levels, but if you aren't producing enough insulin then the trips to A&E may have been a sensible move.

TL;DR - Jardinace can mask some of the symptoms of DKA which can lead to EKA.

I raised the issue of ketosis versus ketoacidosis and was told no. Angry that ive spent 2 days in a&e and wasting their time/resources. From my 1st diagnosis ive always tried to keep informed etc. Have become a bit obsessed with ketones now tho. Have ordered ketostix, just to keep an eye on things until they at least settle down xx

 

[Resurgam]

Your liver might be so much happier that your metabolism is picking up a bit and you could not actually need so much medication. Keep testing the glucose levels as well as monitoring ketones, for your own peace of mind - but you might get told that you need to consume more carbs to 'cover' the medication - but I am sure that you can see the lack of logic in that advice.

 

[bonkers82]

Your liver might be so much happier that your metabolism is picking up a bit and you could not actually need so much medication. Keep testing the glucose levels as well as monitoring ketones, for your own peace of mind - but you might get told that you need to consume more carbs to 'cover' the medication - but I am sure that you can see the lack of logic in that advice.

The basic improvement on my health was almost instantaneous. Ive always had a pulse of around 130 bpm. Its now down to around 80-90. In the 3 weeks of not drinking alcohol during the week ive lost around 7lb, which i had attributed to the lack of alcohol. A&e says this blip with ketones is the change in calories and bidy adjusting to the change. Advised me that providing im not acutely ill etc to eat as normal and drink plenty(obviously not alcohol lol). Im quite confident that keeping an extra eye on glucose levels and ketones that i can get over this blip and reap the benefits xxx

 

[bulkbiker]

A&e says this blip with ketones is the change in calories and bidy adjusting to the change. Advised me that providing im not acutely ill etc to eat as normal and drink plenty(obviously not alcohol lol).

Did you tell them you were taking Jardiance? Are you still taking it?

 

[bonkers82]

Did you tell them you were taking Jardiance? Are you still taking it?

Yes told them im taking jardiance and wasnt told to stop etc. Just drink plenty and eat as normal. As long as i feel well thats ok

 

[Rachox]

Here’s an article about euDKA that is DKA with normal blood sugar, which can happen with certain drugs including Jardiance, I’m not familiar with this website but it seems to confirm that you weren’t wasting the hospital’s time at all:
https://rebelem.com/euglycemic-dka-not-myth/
I hope you’re feeling reassured now.
Oh and I use the Caresens Dual blood glucose meter that has the facility to test ketones too if you’re interested:
https://shop.spirit-health.co.uk/collections/caresens-dual