Type 1 Ketosis & Hospital Checkups

[Peppergirl]

At annual appointments the nurse always does a urine dipstick test for ketones. Now I am in ketosis I am a bit concerned about the reaction to ketones from the nurses/consultant, although HbA1c is normal and I explain what I'm doing (works). I understand the need for checking in case of DKA. In fact, my DSN gave me a ketone meter just in case as I'm moving to a pump 19 September. So I wondered how much of an issue other type 1's on low carb have experienced with this? A normal HbA1c and libre 'proof' is OK? I forgot the urine sample last time and there was no issue so I may do this again, just to avoid all the questions.

 

[Snapsy]

I remember a dipstick test at the GP, first thing in the morning - I was there for bloods and urine - a few years ago - and she said 'oooooooooooooh, you've got ketones', with some alarm. I wasn't low carb at the time, but I'd had had an early evening meal and fasted until my appointment.

I said 'but there's no glucose in there, right?' and told her that I had fasted, as per her request, at which point she laughed, relaxed, and said 'no, quite right'.

My understanding has been that most people will have ketones after an overnight fast.

 

[tim2000s]

DOn't worry about it. I've had that on a few occasions and a brief discussion with the consultant/nurse and telling them not to bother with the dietitian if they offer it has worked.

 

[michita]

Hi @Peppergirl,

I have the same worry and understand your concern.. Some doctors are not familiar with difference between ketosis and DKA and this can create a stressful situation.

luckily my consultant doesn't check ketones at the routine checkup (though my GP nurse does). I feel there really aren't many type 1s on low carb diet and in ketosis.

If your consultant knows you are on low carb diet and he/she is supportive, you can maybe very politely ask not to test for ketones. If your BS level is ok they shouldn't have to check your ketones. You can explain the reason honestly. In that way you don't miss out on other tests (albumin test for kidney function etc). This is something I thought I might do.

My ketone level is usually around 1 to 3 and doctors and nurses become uncomfortable quite a bit in my experience.

All the best

 

[tim2000s]

you can maybe very politely ask not to test for ketones. If your BS level is ok they shouldn't have to check your ketones.

Michita, generally, the urine testing is done using a combined test stick, of which one of the pads is ketones, so it's quite hard to not test for them!

 

[michita]

Michita, generally, the urine testing is done using a combined test stick, of which one of the pads is ketones, so it's quite hard to not test for them!

@tim2000s
I didn't know. Thank u for the info.
I would then just be prepared and face the stressful situation, or eat carbs before the test to be out of ketosis (need experimenting beforehand).... or forget the sample

 

[tim2000s]

I would then just be prepared and face the stressful situation, or eat carbs before the test to be out of ketosis (need experimenting beforehand).... or forget the sample

Not sure why you need to stress. If your glucose levels are normal and you are maintaining good glucose levels, it's your decision to eat as you do, and if your consultant or DSN questions it, simply point out to them the results you are getting.

 

[michita]

Not sure why you need to stress. If your glucose levels are normal and you are maintaining good glucose levels, it's your decision to eat as you do, and if your consultant or DSN questions it, simply point out to them the results you are getting.

I will .... try. I had bad experiences with doctors and nurses re low carbing in the past and I'm still a bit afraid of their reaction. I'm probably stressing myself for nothing. My BS level is good and I'm comfortable with my diet.

Thank u for the comment