What place has this on the forum?

[benedict]

Admin,

Just noticed on the community pages that this advice has now been amended, so did the health-care professionals you consulted verify that ketones are not in fact dangerous or harmful to the kidneys?

Just need to know, as I said previously my consultant seems to think they are detrimental to the kidneys and the following nhs information would appear to suggest this also:

http://www.cks.nhs.uk/patient_informati ... t/ketosis#

Nigel

Hi Nigel

It was felt that ketones should not be labelled as dangerous as such.

In high quantities they can be very dangerous, however, there doesn't seem to be convincing evidence that ketones should be 'dangerous' at low levels, therefore it was felt that the statement could be misleading.

Many thanks for the question
Benedict

 

[phoenix]

Ian,
I think Jopar was replying to Hanas original statement,

Ketones in the system associated with low blood glucose levels are merely a sign that fat is being burned. Only when associated with high blood glucose levels are they a symptom of a harmful process, probably ketoacidosis,

This is clearly not always the case in people with type 1 diabetes where low circulating insulin can result in DKA at low blood glucose levels. I accept that in your case you probably produce plenty of insulin and therefore any ketones will be very small.
I have read that in some areas of the developing world people are quite frequently diagnosed with T1 and euglycemic DKA. Euglycemic DKA can also occur during pregnancy and in childhood, although rare it has also occurred on low carb diets (a case of a type 1 on the South beach diet was reported in the Journal of Med case reports)
People with T1 and those with type 2 who are now producing little insulin need to be aware that ketones are potentially dangerous. Ketones can develop extremely quickly, in some people when a pump stops delivering it can happen within a few hours; for that reason I was taught to test for ketones every morning and act accordingly ie enough insulin to get rid of the ketones, whatever the blood glucose level. You may not feel at all ill in the initial stages of DKA (I went out for a bike ride before my symptoms developed!), Treating the presence of ketones early enough will hopefully prevent DKA.

 

[hanadr]

I would question the bg levels given in descriptions of Euglycaemic DKA as "Low". Anything in double figures is not low. I suspect those are pretty old definitions. Euglycaemic, means [normal sugar]. 16 is NOT normal.
If I recorded 16 on my meter, I'd be worried about more than ketones.
However, I was commenting on careless use of chemical names. Chemical naming is pretty tightly defined.
Hana

 

[noblehead]

Hi Nigel

It was felt that ketones should not be labelled as dangerous as such.

In high quantities they can be very dangerous, however, there doesn't seem to be convincing evidence that ketones should be 'dangerous' at low levels, therefore it was felt that the statement could be misleading.

Many thanks for the question
Benedict[/quote]

Thanks for the prompt reply Benedict!

So ketones are not in fact dangerous hence why it was removed from the community pages, what was the health-care professionals you asked view on the long-term effect on the kidneys? The NHS literature seems to suggest that they are indeed harmful, and as I said in my earlier posts my present Endocrinologist and those before him advise all patients to check and avoid ketones due to the harmful effect on the kidneys............so as you can see I am still none the wiser!

Hopefully you can look into this for me please and get some further clarification on whether ketones are indeed ''harmful'' (but not dangerous).

Many thanks

Nigel

 

[benedict]

Thanks Nigel

what was the health-care professionals you asked view on the long-term effect on the kidneys?

Sorry Nigel I can't say too much more than that it was felt that the statement saying that ketones are intrinsically dangerous was worthy of editing.

As a type 1 diabetic myself, I would love to see compelling evidence one way or another as to whether ketones over time are harmful to these organs of ours.

Benedict

 

[hanadr]

I don't know about any other low carb T2s, but since I can't even get blood glucose test strips, I certainly don't get ketone ones, however I do have access to urine strips and I know that I rarely produce any ketones. Nevertheless, I am married [39years] to a lifelong T1 and have seen both DKA and benign ketones. I don't need to have experienced everything myself, when I've lived alongside it for so long. I have had to act very quickly on many occasions. Many more than most healthcare professionals I'm sure
Hana

 

[noblehead]

Thanks Nigel
Sorry Nigel I can't say too much more than that it was felt that the statement saying that ketones are intrinsically dangerous was worthy of editing.
Benedict

Thanks again!

I just thought the professionals whom you consult when writing the advice on the community pages might have had a view on this matter!

Not to worry I'll stick with what I have been told!

Nigel

 

[jopar]

I would question the bg levels given in descriptions of Euglycaemic DKA as "Low". Anything in double figures is not low. I suspect those are pretty old definitions. Euglycaemic, means [normal sugar]. 16 is NOT normal.

I don't know about any other low carb T2s, but since I can't even get blood glucose test strips, I certainly don't get ketone ones, however I do have access to urine strips and I know that I rarely produce any ketones. Nevertheless, I am married [39years] to a lifelong T1 and have seen both DKA and benign ketones. I don't need to have experienced everything myself, when I've lived alongside it for so long. I have had to act very quickly on many occasions. Many more than most healthcare professionals I'm sure

Now firstly hana I read this thread from several angles...
Not only as a T1 diabetic of over 20 years.. But also a person who’s suffered low level DKA and that of having a T1 diabetic husband he’s had it for the same length of time as your husband we just haven’t been married as long!

Now I would be pretty concerned if my meter said 16mmol/l ketones present or not, but if you read the article being pedantic as you want people to be over chemical etiquette you would realise that the reference made to 16mmol/l and normal levels is based on that full DKA normally hits above these levels you should had furthered noted that on rare occasions that DKA can set in below 10mmol/l....

Benign ketones, now that’s phrase are you referring to ketones that are produced as procurer to DKA the ones that tell you that body fat is being burnt for fuel which one could say aren’t dangerous which at the beginning is probably reasonable true well for those that are non-diabetic or T2 so still producing there own insulin to prevent the body going into DKA...

But as I’m proof that those Benign Ketones and the assumption that my BG is with in normal range as in its not gone past the 8mmol/l mark doesn’t mean that they aren’t going to turn into something very dangerous and life threatening...

Remember I’ve have actually been admitted to hospital more than once (19 years ago being the last time) with DKA and normal blood glucose levels..

So when the HCP’s tell me as a insulin using diabetic, ketones are dangerous and something to be concerned about if they appear, I am from sheer personal experience going to believe what they say....
So from my experience, Ketones can be very dangerous and life threatening and should be treated with extreme caution..