Smell of ketones? Newly diagnosed

Celtic Woman · Apr 4, 2011

Hi there,

I am new to the forum, new to diabetes and just wanted to ask for some advice. I am 42 years old and type 2.

I randomly tested my urine (mum is diabetic) and found glucose 3 weeks ago, my blood test at home was 14.7. I then saw my Gp and underwent fasting glucose check which was 14.2. He confirmed I am a diabetic, referred me to retinopathy and asked me to see the practice nurse. This was two weeks ago and my appointment isn't for a few days yet.

My partner has told me that I smell of ketones and I am feeling quite unwell today with some nausea,tiredness etc. I have also had a strange salty taste which I can't get rid of in my mouth for the last few days. Do I need to see someone more urgently? Or will I be ok to wait until my appointment later in the week.

I have been trying to educate myself online and reducing my carbohydrate intake but have no idea if this has made any difference as I have no way of monitoring my sugar level.

Could anyone advise? :|

daisy1 · Apr 4, 2011

Hi Celtic Woman and welcome to the forum. I think you should phone NHS Direct straight away and tell them what you've told us and see what they say.

You also need to get yourself a testing kit and start testing so you can see what your levels are like. You may be able to get one given to you by your doctor, or maybe get a free one by phoning manufacturers and saying you will be testing, say, 8 times a day as it's their strips they want you to buy or you may have to just buy it yourself if you can't get one any other way. If you have problems getting the strips there is a link in this information called Tips for Strips which should help you.

As you are newly diagnosed here is some information written by the Forum Monitors for new members which will tell you all sorts of things you need to know:

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS.

Postby sugarless sue » 02 Oct 2010, 17:49
Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091

Sue/Ken

Snodger · Apr 4, 2011

If your partner can smell ketones it's best to get seen sooner rather than later, I'd say.
You don't say what kind of diabetes your mum has - can she help out with advice/lend testing strips while you are waiting to see a health care professional?

ams162 · Apr 4, 2011

i would go see someone as a matter of urgency dont leave it if u feel unwell better to get checked out and it be for nothing than leave it and be really ill go see someone as soon as possible

anna marie

Celtic Woman · Apr 4, 2011

Thank you all for your replies.

Mum has dementia and is not really able to help much unfortunately.

I have called my surgery to try to get seen earlier than the appointment I have but there are no appointments available. I am not keen on calling NHS Direct as I know they are likely to say "Go to A&E" or something-which involves a 30 mile trek for me and feeling so groggy I would really prefer not to drive.

From what I have read, it is unusual for type 2 to get ketones? Is that right? Also, with my FBG of 14-is there likely to be any immediacy?

To be honest, I don't know what to eat, whether to exercise or not or where to start in lowering my sugar levels! I have been reducing carbs from the obvious sources the last two weeks but seem to be feeling worse, not better. I am utterly baffled at the moment. :?

lovinglife · Apr 4, 2011

Hi CW and welcome to the forum

I think like all the othrs have said you need to be seen sooner rather than later -

Celtic Woman said:
From what I have read, it is unusual for type 2 to get ketones? Is that right? Also, with my FBG of 14-is there likely to be any immediacy?

unusual but not impossible - I had keytones on diagnosis - the advice given to me by DSN nurse while I was in hospital was

three consectutive readings of 13 or above with keytones - get myself to A&E

Snodger · Apr 4, 2011

Celtic Woman said:
I have called my surgery to try to get seen earlier than the appointment I have but there are no appointments available. To be honest, I don't know what to eat, whether to exercise or not or where to start in lowering my sugar levels! I have been reducing carbs from the obvious sources the last two weeks but seem to be feeling worse, not better. I am utterly baffled at the moment. :?

Three things
1) Can you get yourself to Boots or similar and buy yourself a blood glucose meter asap? That will really make a difference to the baffled-ness - you will be able to see what is happening and whether your blood sugars have risen higher than the 14 or so they were last time you were able to check. They easily could have done - diabetic blood sugars can shoot up within an hour, never mind several days or weeks. It will also mean you have some concrete evidence to take to the doc to ask for an emergency appo, which brings me to my second point:
2) If you say to the GP that you have very high blood sugar and ketones and are feeling nauseous, too bad to drive to A&E, they must surely be able to fit in an emergency appo? Are you also finding you are hyperventilating at all? If so do mention that as well. The key warning signs they will be alert to are hyperventilation, thirst/dehydration, nausea/vomiting, ketones, weakness, blurred vision, confusion/drowsiness, cramps.
3) If you really have reduced all carbs but still feel awful, and your ketones are very high, there is a possibility that you have Type 1 - people do develop it as adults. A friend of mine was diagnosed Type 1 last year aged 48. You might just not be producing enough insulin.

let us know how you get on and good luck

dectjoh · Apr 4, 2011

Have you lost any significant weight in the past few weeks since discovering the high BGs? Are you breathless? If so, I wouldn't wait until next week. I was diagnosed back in December after a significant amount of weight loss which I put down to stress at work. When I sought help, I was breathless and had severe indigestion symptoms. I was told I had 48 hours left in me untreated. Diagnosed Type 1 at 40 years old.

Good luck, and keep us posted.

Tracy

Celtic Woman · Apr 4, 2011

Thank you all again!

I am not breathless, thirsty or passing urine frequently at all. I just feel washed out, tired and like I am walking through and thinking through mud. Just sluggish and everything is an effort. I am nauseous, weak, and tired. I have no weight loss ( well done 'lovinglife' on your phenomenal weight loss). I have so many things to tackle but your stories and attitudes are inspirational.

I have asked my dad if he can get mums spare monitor to me so I can monitor my blood levels. Will let you all know how I get on and thank you so much for your advice. Quicker than any medical system I know! :lol:

viviennem · Apr 4, 2011

In your place I would follow Snodger's advice, particularly paragraph 2, and phone the surgery again. Even Type 2s can get ketoacidosis, and while extreme low-carbing can produce ketones, it shouldn't produce nausea, weakness and tiredness.

Don't let the receptionist put you off - mention possible ketoacidosis.

Good luck!

Viv 8)

Celtic Woman · Apr 4, 2011

I have now borrowed mums blood glocose meter and tested again. My BM is now 24. Have rung the surgery again and they still won't see me. Is there anything I can do to help myself here with homecare- what do I eat? M nurse appointment is on Wednesday afternoon.

I am sorry to be a nuisance with all my questions but I don't want to over react to minor symptoms unnecessarily.

xxxx

Sid Bonkers · Apr 4, 2011

Hi Celtic Woman, if your breath smells of pear drops (ketones) and your bg is 24mmol/L I would advice you to go directly to A&E now, right now, immediately.
High blood glucose and ketones can be a very very dangerous combination.

DO NOT WAIT FOR YOUR GP, go now, seriously.

Good luck.

donnellysdogs · Apr 4, 2011

Just incidentally as well, try to make sure you are drinking some plain water.

ams162 · Apr 4, 2011

im hoping by now u have visited a and e please let us know how u are getting on a bs of 24 and feeling unwell is worrying hopefully u have had some treatment

anna marie

Smell of ketones? Newly diagnosed

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