Type 2 Some help with ketones

Caeseji

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Hi there all!

Yesterday I ended up at A&E as i noticed there was a high level of ketones in my urine (using Ketostix test strips) and was advised by my GP office and 111 to go to the A&E because it was a massive risk as a T2 diabetic of course. Testing my blood sugar at the time got me a round 7.0 and later whilst in the A&E two hours after food I was at an 8.1. The doctor there said that I was okay to go but to keep an eye out for symptoms of DKA, I wasn't at all symptomatic at all, no sickness or pain at all, no confusion either along with my breath just smelling normal and not the joyous pear drop/acetone and I was feeling a little dry-mouthed but I didn't need to go to the toilet more than usual and I generally improved my thirst when I stopped freaking out about the whole thing.

Now the question is, with me dropping nearly all my carbs out of my life all of a sudden over the past few weeks would this cause the issue? The doctor said it would do, I was doing too much too fast, I was coming down from a massive blood sugar level these past few weeks and I am overweight. He did confirm I still had elevated ketones in my urine and I still seem to be fine at the moment too just a bit gassy more than anything else but I wanted to ask your opinions.

Thanks!


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Indy51

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There is a difference between being in nutritional ketosis from a lower carb diet and the condition ketoacidosis. If you do an internet search, you'll find many articles. Here's a video about it:

 

Indy51

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DKA is especially unlikely if you aren't taking medication. It can be an issue taking SGLT2 inhibitors and/or insulin.

You didn't say which medications you're taking - can you please advise?
 
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Caeseji

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@Indy51 That would be slow release metformin/Glucophage 500mg x 3 and Sitagliptin once per day on both.
 

Indy51

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I don't think either of those drugs are SGLT2 inhibitors, so DKA is unlikely in the absence of very high BG in addition to ketones. The SGLT2 inhibitors can cause a DKA like syndrome even with low BG levels - see this post elsewhere on the forum:
https://www.diabetes.co.uk/forum/th...-on-the-risk-of-diabetic-ketoacidosis.104325/

Urine strips are a fairly unreliable way of measuring ketones - blood testing is more accurate (though the strips are more expensive).

There are many articles online about 'ketosis vs ketoacidosis' if you search for that phrase.
 
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Ponchu

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My ketones level during the rapid weight loss has been steady at .5 to a high of 1.5 monthly.

This is suggestive of efficiency.

It was likely higher in the very beginning but I didn’t blood test early.
 
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Caeseji

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@Indy51 Those are some amazing resources and watching that video did open my eyes to a lot so I thank you for that and I appreciate you sharing your experiences there too @Ponchu

I'm inclined to agree that the urine strips are utterly terrible for testing for such things given how inaccurate they can be coupled with the fact they only really detect one part of the ketones. Thankfully I am back to a low slash heading down to trace readings again after feeding my body a little more carbs.
 
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Ponchu

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For just starting out, the inexpensive strips can tell the newbie, “you’re in!” which can help w inspiration.

Trying to get a level from them...not so accurate.
 
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Resurgam

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ketones are the result of fat burning, and are indicative of a low carb diet doing its usual efficient task of reducing blood glucose levels and your metabolism working as it ought to do.
Usually it is dangerous to have ketones AND a high level of blood glucose. If your blood glucose is at a low level that usually means that you will not go into ketoacidosis.
 
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Caeseji

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@Resurgam Consistently reading in the 7's when I test just after I wake up so blood sugar really is going down from my previous levels so like the doctor said it's probably nothing to worry about.
 

Charis1213

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I have never tested myself for this . I just got on with the diet and noticed my blood sugar readings down .
 
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