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Oooooh trace Ketones...?

S

Sanober

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Not really knowing what's going on inside my Endocrine system!!!
Ok for the past few three months, when ever I got over 13 on the glucose self test read I was told to check for Ketones, I never ever got any.

So I stopped bothering with it and being a good girl I'm shutting up and taking Gliclazide (which I've known since I started, it's not doing much...)

Anyway, I've been varying from 9 - 13/14 readings but a couple of nights ago I got a 15.6, 5 hours after lunch (my mum's home cooked basmati rice and chicken...) yip my sugar was that high even after 5 hours of not eating. In the morning I had a zero Total Greek yoghurt (so virtually no carb) and then probably around 50-60g for lunch.

I used my Ketostix and spotted the pink square for trace Ketones :?: I thought hang on, large carb lunch and not eating for several hours, glucose is still high and now trace ketones.

So I ignored it and the next morning woke up with 13.4 glucose and retested for Ketones, none.

Yesterday evening I got a reading of 14.3 (total carb intake 50g for the whole day, nothing is making sense to be honest these last few months)and I got trace Ketone reading again.

However today at a reading of 15.4 (post exercise and I had 4 crackers so 20g carb before it), no Ketones.

Is this a sign of something new with my on going Diabetes progression? Or should I just keep an eye and watch that it doesn't go beyond trace Ketones?
 
Hi S

You are having the GAD test done right? I really hope this sheds a bit more light on your situation. If you are having sugars as high as this and are starting to kick out Ketones , then you must get onto your team and let them know this.
Have you got an electronic Ketone monitor, or are you using the sticks? I have a meter, they are a lot more reliable , I have just been to look for it for you but can't find it at the moment Shows how often I test for Ketones Anyway it's an Abbott ,Optium one, I think :think: . Ask for one off your team. And you are right, you now really need to keep a close eye on it.

It sounds like you are doing all you can to help yourself, but it does sound like you are progressing more and more towards Type 1 and possibly insulin treatment..well certainly if on the meds you are well into double figures with Ketones. I would give your DSN a ring tomorrow and see what she says.

Take care and let us know what happens
 
Thanks Fallenstar

I am indeed awaiting the GAD test result. :shh:

I use the Ketostix, the only reason I even have them was because following an op to remove an ovarian cyst at the start of August which led to readings in the high 20s about a week later (infection).

I checked out the meter model you mentioned looks nifty

Can I ask why Ketostix aren't as reliable? Also, should I really tell the Diabetes team just now do you think? I do have a tel no. to call since I got the Glic given to me or should I wait until the Ketones level is higher?

Thanks for saying I'm doing all I can - I really am. My Diabetes just seems to be progressing further and the more I'm trying the worst things seem to get.

I just started laughing when the trace pink square showed the first time on the Ketostix. I ran over to my husband waiving at him and shouting 'what's going on now eh?' :lolno:
 
Hi Sanober!

When are you back at the hospital for your GAD tests? You really can't let this go on much longer. If the Glic hasn't worked by now I don't think there's much chance of it working at all. Have you stopped losing weight? I know you said you weren't losing much, but weigh yourself regularly - my weight was falling slowly and then it fell suddenly. All the things you're describing sound like I was before my Type 1 diagnosis. I also had trace Ketones at my Type 1 diagnosis, even though my HbA1c was OK - the consultant said it was a result of the high after food readings I kept getting and that my body was unable to use the food for energy so was burning fat. Things didn't get better until I was on fast acting insulin. Keep a close eye on it, and pester your team to speed things up - they took 3 months to get me in to see the consultant and a further 3 months to do the GAD tests that actually got me my diagnosis! By then I was really ill - keep on at them even when you don't feel like it!

Hope you get it sorted soon.

Smidge
 
Hi Sanober!

You must have been posting as I was typing :lol: Glad you've had the tests done now. Let's hope they reveal something.

Keep your chin up!

Smidge
 
:lol:

Thanks so much Smidge, I feel like I pester the medics constantly but I do wonder if they're just waiting for me to just collapse one day. I know, morbid.

Saying that, although I didn't like the last Diabetologist doc she did say 'test for Ketones if over 13', but didn't advise me what level to call the doc/NHS24 etc.

I did wonder why she was telling me it will take a few months for the Glic to kick in when the hospital that my GP referred me to nearly 3 weeks ago monitored me for 6 hours once I'd taken my first Glic...she booked me in for next appointment in Feb 2012.

Interesting to know about your weight loss progression. I don't know what I am just now, although a few people including my boss have told me just this week said I'm looking thinner lately and I tried on THREE pairs of trousers today and all too baggy. So I'll get myself on a set of scales.

Got the GAD done last Wed, will get a call once the result's in. If it's negative they will still need to look at why my readings are not going down surely? Don't worry I wasn't going to wait til Feb anyway, I was going to waiti until end of Nov but then the trace Ketones started popping up.

Thanks as always for sharing Smidge, very insightful. it's all starting to really do ma heid in!
 
Hi Sanobar
I agree with Smidge, and she has been exactly where you are now...so knows her onions!

Ring your Team ,let them know you are getting Ketones , how long are they going to let you go on before you get poorly..Im no medic but it does sound like you need some Insulin with figures like that and the ketones...you are burning up your own tissues for energy :shock: Ring em up!

Good luck S, keep us informed
 
Urinalysis is never as accurate as blood testing as it takes longer for waste products to hit the system than the blood. Also not all the ketone bodies end up in your urine.

Not to contradict others, but I personally wouldn't put too much stock in one or two trace ketone tests to be indicative of that much. Low carbing, illness and fasting can all produce ketone bodies and the warning signs are a) moderate to high ketone levels and b) ketones that don't go away. You are supposed to test for ketones when you have two consecutive BG results over 13.9 and if you get consecutive ketone levels (moderate or above) contact an HCP promptly.

Clearly you need to make your own decision on this but I personally wouldn't contact my medical team over trace ketones unless they were becoming a regular thing. Ring them by all means, but I would not be surprised if they don't take it very seriously.

On the weightloss question, the warning sign is really unexpected weightloss as far as I'm aware. Someone dieting and exercising a lot would expect to be losing at least some weight, so it is hard to identify the cause of the weightloss. I was steadily losing weight despite a not very good diet involving too many MacDs and too little exercise. No matter what I ate, I kept losing 2-3lbs a month steadily until I picked up a nasty infection and then I lost 10lbs in about 6-7 days and developed ++++ ketones and HI meter readings. It still took three weeks after hitting that point before I got to see someone about starting insulin. My fasting readings were above 20 permanently and I only had one reading under 10.0 in about nine months. My HbA1c was 13.7%, meaning my average blood glucose was 20.1.

I too was desperate for answers as to why I could not control my sugars. It may well be that you are starting the slide into a LADA form of diabetes, but it may not. The GAD test may give answers but a) be prepared for it to take 6-8 weeks for the results to come through and b) they may not be definitive. A positive result means your diabetes is definitely auto-immune but a negative one does not exclude it as apparently you don't always produce the antibodies reliably all the time.
 
I just think regular readings well up into the teens and ketones is not good, why wait as a lot of us did,to get as thin as a rail and all the other nasties that happened before we were put on insulin. If the meds are not working ,which obviously with the care you are taking with your diet and all the oral meds you are on ,and your high BG ,they are not..then Im sure eventually you will be on insulin..but to me it should be sooner rather than later...you must be feeling pretty rough with those numbers.

to have your trousers hanging off you and people commenting on your weightloss, is not a good sign. I hate to see people in a bad way, and obviously worried. Hopefully the GAD will help, but you must go on how you feel Sanobar...Oh and those strips only have a shelf life of several weeks once opened another reason for a meter.
 
Russ, I appreciate what you're saying and it looks like you along with others here have not been treated too well/quickly by the medics. I'm just keen to get the answers. I don't know if I am being impatient but I am sometimes scared of going through the sudden onset that you guys have experienced. I'm glad there are more like me that are not the usual cases of Diabetes either, however remember I've not had a clear cut diagnosis yet so am still at the 'searching for answers' stage.

It's been a year now since my 'pre-diabetes' and was told don't worry and I would likely get in my 50s but keep my weight/diet good....a few months later officialy Diabetic (despite adapting diet/exercise further) and now a sudden jump in my A1c from steady 7% (which despite my very best efforts I failed to down to the 5 -6 %)

I agree Russ, am not relying on the GAD test to confirm things, as keen as I am to control this condition even I have to accept that it may not give me the answers.

I went to my lovely local DN today as I couldn't face the D-clinic after that last snotty woman.

The nurse pointed out that I had gone on to double my dosage again 6 days ago (without advice I know), which normally they would phase in after 4 weeks. However, she did emphasise everyone's different, some respond quickly to medications in general and some don't.

She doesn't want to me to increase further for at least 4 weeks, keep testing, see if my fast readings reduce. If they're going up the way she want me to call back. I've been on 160g total daily so 2 x 80mg, she thinks my fast reads are down a bit the last three days (they're steadier I agree but around the 13 mark).

She mentioned about Ketones - told me to test when over 15 and even if trace Ketones AND if I feel awful to get in contact. She wasn't too quick to dimiss trace Ketones in my case as I'm 'unsual'. She is concious that I am symptomatic and warned me at the current level of Glic I'm susceptible to Hypos (I doubt it very much to be honest...)

The peeing/thirst has actually decreased with the Glic, so that's one bit of improvement.

She was very nice as always, and actually apologised that she didn't have all the answers and she isn't aware of anyone in the N.Glasgow area that's like me even when she has talked to some other D-nurses for the north area!

Both my parents are T2s - but 'typical cases' but I have a first cousin who is skinny T2 and on pills/diet for 5 years and is controlled, no one else in our vast family has Diabetes - and the reports so far still haven't ruled out other potential genetic mutations that have led to my current condition.
I suppose I should consider myself lucky in that at least I've had tests that loads of people here don't even get considered for!

Thanks all for guidance, always appreciated.
 
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