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Normal BG with ketones

S

Samara1

Member
Messages
20
Hi,

I don't know what to do or what to think and I would really appreciate your help.
A few days ago, I tested my ketones because I wasn't feeling 100%, I was at 0.7. I monitored it all day, in the afternoon I was back to 0.1 but at 9pm, I was at 0.9... I didn't know what to do.. my BG was ok (7mmol)... the next day, I called my nurse who told me to relax that I should not worry or do anything. I have just tested again and I'm now at 0.8.... my BG is not high. What does it mean? I'm stressed because I have mild muscles pain and my mouth is very dry...it reminds me of when they diagnosed me 2 years ago (I had DKA).

Thanks,

S
 
Everyone is always burning some fat for energy which explains the low ketones. I run my ketones from 1.5 to 3 mmol/l in nutritional ketosis as I fast and eat a low carbohydrate diet. As long as you have background insulin, you are safe. If you are unwell and have blood sugars continuously over 13 mmol/l then you should follow sick day rules and take extra insulin and monitor your ketones.
 
ert said:
Everyone is always burning some fat for energy which explains the low ketones. I run my ketones from 1.5 to 3 mmol/l in nutritional ketosis as I fast and eat a low carbohydrate diet. As long as you have background insulin, you are safe. If you are unwell and have blood sugars continuously over 13 mmol/l then you should follow sick day rules and take extra insulin and monitor your ketones.
Click to expand...

Thanks, and what is considered a low carbs diet? I eat around 120gr per day and would like to eat more than that but I'm afraid of no being able to manage my BG...is it safe to exercise with a ketone level at 0.7?
 
Samara1 said:
Hi,

I don't know what to do or what to think and I would really appreciate your help.
A few days ago, I tested my ketones because I wasn't feeling 100%, I was at 0.7. I monitored it all day, in the afternoon I was back to 0.1 but at 9pm, I was at 0.9... I didn't know what to do.. my BG was ok (7mmol)... the next day, I called my nurse who told me to relax that I should not worry or do anything. I have just tested again and I'm now at 0.8.... my BG is not high. What does it mean? I'm stressed because I have mild muscles pain and my mouth is very dry...it reminds me of when they diagnosed me 2 years ago (I had DKA).

Thanks,

S
Click to expand...
Hi Samara

I can understand your concern, I have also been hospitalised with DKA. However I think DKA only develops when you also have high blood glucose, usually due to an infection. How are you measuring your BG? As you are not feeling 100% are you confident this is correct? Test strips in date? Or if a Libre can you finger prick to double check? If still ok then there are other reasons to have ketones. Are you going a long time between eating? This can cause ketones. You mentioned you were ok in the afternoon, is that after lunch? Are they rising when you haven’t eaten for 4+ hours? Or after a very low carb meal?
 
Hertfordshiremum said:
Hi Samara

I can understand your concern, I have also been hospitalised with DKA. However I think DKA only develops when you also have high blood glucose, usually due to an infection. How are you measuring your BG? As you are not feeling 100% are you confident this is correct? Test strips in date? Or if a Libre can you finger prick to double check? If still ok then there are other reasons to have ketones. Are you going a long time between eating? This can cause ketones. You mentioned you were ok in the afternoon, is that after lunch? Are they rising when you haven’t eaten for 4+ hours? Or after a very low carb meal?
Click to expand...
Hi,
I have a sensor, so when I have a doubt I finger prick and yeah both sensor and monitor are showing the sames figures. I didn't feel "sick" but a bit "weird" and now I have no other symptoms than a light muscle pain and a dry mouth.
When I tested the first time (when my level of ketones was at 0.7) it was before breakfast, then I monitored and checked 2h after my lunch and it was OK. Then I tested again before eating my meal at 9pm and it was at 0.9. My meals are usually at 8 am, 1pm and 8pm so yeah, I can definitely spend over 4h without eating. Is it a problem? I have just increased my levemir of 1u as my body seems to need more insuline...don't know if I should change anything else...do you think I can exercise?
Thanks
 
Samara1 said:
Hi,
I have a sensor, so when I have a doubt I finger prick and yeah both sensor and monitor are showing the sames figures. I didn't feel "sick" but a bit "weird" and now I have no other symptoms than a light muscle pain and a dry mouth.
When I tested the first time (when my level of ketones was at 0.7) it was before breakfast, then I monitored and checked 2h after my lunch and it was OK. Then I tested again before eating my meal at 9pm and it was at 0.9. My meals are usually at 8 am, 1pm and 8pm so yeah, I can definitely spend over 4h without eating. Is it a problem? I have just increased my levemir of 1u as my body seems to need more insuline...don't know if I should change anything else...do you think I can exercise?
Thanks
Click to expand...
Hi

I get ketones easily when sick with high blood sugar and normally too. My diabetic nurse told me it’s very common to get ketones if you haven’t eaten for 4 hours plus and these are harmless. Sounds like this is what is happening with you too.
I clicked on the link posted by Jonathan183 above for Dr Bernstein and he is definite that it’s the high blood sugar you need to be concerned about, ketones with blood sugar in range is the body working normally. Excellent link, I hadn’t realised he had posted loads of videos on YouTube. Thanks Jonathan.

So if you have ketones and normal blood sugar due to not eating for 4+ hrs you won’t need extra insulin, the opposite will apply. A small snack would lower the ketones in this situation. However as they are a part of the body functioning normally there is no need for you to do this. And you probably wouldn’t want to add snacks and possibly inject But this explains why they lower after you have had a meal. I think the same is happening to me, I eat at 8.30am 2pm and 7pm. No snacks.

I have no idea about exercise with ketones, but if you are feeling ‘off’ then maybe wait until you feel ok? I am sure though I must have exercised while having ketones and normal blood sugar, if I were you I would have my insulin and jelly babies with me for any odd reaction if I was not feeling 100%. Or maybe someone else knows? You are definitely right to keep an eye if feeling ‘off’ and stay well hydrated but with normal blood sugars ketones are fine. As you have increased your Levemir tonight keep an eye tomorrow you don’t go too low.
 
Hertfordshiremum said:
I have no idea about exercise with ketones, but if you are feeling ‘off’ then maybe wait until you feel ok? I am sure though I must have exercised while having ketones and normal blood sugar, if I were you I would have my insulin and jelly babies with me for any odd reaction if I was not feeling 100%. Or maybe someone else knows? You are definitely right to keep an eye if feeling ‘off’ and stay well hydrated but with normal blood sugars ketones are fine. As you have increased your Levemir tonight keep an eye tomorrow you don’t go too low.
Click to expand...

People get different blood glucose and ketone responses to exercise. Some get a decrease in blood glucose, I get a blood glucose increase. Some report an increase in blood ketones during others report a fall in ketones during exercise. I only check for combinations for me which could be problematic - low blood glucose with low ketones or high blood glucose with high ketones, starting by checking blood glucose.

Peoples tolerance to ketones also varies - I find I can have ketones in the 5 to 6mmol/l range and still feel OK unless blood glucose is also elevated. I have felt sick with the combination of ketones in the 6 to 7mmol/l range and blood glucose greater than about 7.6 mmol/l. Some people feel unwell with much lower ketone levels.

I'd suggest glucose tablets or glucose liquid for blood glucose corrections - Dr Bernstein's recommendation to avoid overshoots and get reliable results because it does not require digestion. It's in his book Diabetes solution and it will be in at least one of his videos.
 
Hertfordshiremum said:
Hi

I get ketones easily when sick with high blood sugar and normally too. My diabetic nurse told me it’s very common to get ketones if you haven’t eaten for 4 hours plus and these are harmless. Sounds like this is what is happening with you too.
I clicked on the link posted by Jonathan183 above for Dr Bernstein and he is definite that it’s the high blood sugar you need to be concerned about, ketones with blood sugar in range is the body working normally. Excellent link, I hadn’t realised he had posted loads of videos on YouTube. Thanks Jonathan.

So if you have ketones and normal blood sugar due to not eating for 4+ hrs you won’t need extra insulin, the opposite will apply. A small snack would lower the ketones in this situation. However as they are a part of the body functioning normally there is no need for you to do this. And you probably wouldn’t want to add snacks and possibly inject But this explains why they lower after you have had a meal. I think the same is happening to me, I eat at 8.30am 2pm and 7pm. No snacks.

I have no idea about exercise with ketones, but if you are feeling ‘off’ then maybe wait until you feel ok? I am sure though I must have exercised while having ketones and normal blood sugar, if I were you I would have my insulin and jelly babies with me for any odd reaction if I was not feeling 100%. Or maybe someone else knows? You are definitely right to keep an eye if feeling ‘off’ and stay well hydrated but with normal blood sugars ketones are fine. As you have increased your Levemir tonight keep an eye tomorrow you don’t go too low.
Click to expand...

Thank you so much for your advice and info. It really helps me. For the past few days, my body has definitely reaquested more insuline...I don't really understand why. It seems that from a day to another, my carb ratio decreased significantly....I was at 0.7 now 0.5. I'm still investigating
 
Samara1 said:
Thank you so much for your advice and info. It really helps me. For the past few days, my body has definitely reaquested more insuline...I don't really understand why. It seems that from a day to another, my carb ratio decreased significantly....I was at 0.7 now 0.5. I'm still investigating
Click to expand...
You are welcome, I still look on here for advice, it’s a constantly changing condition! I think Antje, a moderator, was talking about changing ratios and insulin requirements recently
#Antje77
 
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