• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Worried about ketoacidosis

I just see this and appreciate the advice, today i'm on a huge 14.9 and oh so thirsty like my mouth has been glued up, cup of tea and breakfast i think. - Now I have never been able to eat as soon as i wake up, i have always had to leave it an hour or perhaps more, before i was diagnosed i'd skip it and have something lunchtime.
 
Is that you’re waking number? Eat anything different for tea last night? Feel like you might be getting sick? Sleep badly?
If you can’t eat anything (a boiled egg maybe or a slice or two of cheese?) then lots of people like a coffee with double cream to start the day (disgusting to me but I’m the odd one apparently)
 

Yes that was waking and I had the meat loaf, recipe supplied by @Goonergal , i was in bed early because of exhaustion and was up at 4am for 10 minutes then returned, i didn't sleep badly as far as i remember. Honestly I think i'd be ill if you put food in front of me within the first perhaps hour of getting up then i would have to force myself, i can eat early if i'm up at say 4.30 - 5am for the day and can eat by about 7.30am but usually, no, i cannot however go without my tea and as much of it as possible, i probably have three mugs before i start to feel with it, coffee first thing is utterly gross imho.

I had egg and bacon at around 10.30 am and my sugars did go down to 8.7, i done some gardening and then went back to sleep- yes, far too much here but i just can't help it, woke up on 10.2 and 2 hours later 8 and have a few cups of tea inbetween.
 
I understand the reluctance to eat on waking but even a few mouthfuls helps me and I thought it might be worth trying. Other than the tiredness how are the other symptoms doing?

Have you had other things checked re the tiredness in case it’s not the diabetes? Eg thyroid, b12, iron and ferretin, vitamin d or maybe if this continues for a while without showing signs of improvement ask for a cpeptide to check what levels of insulin your body is capable of producing - you haven’t said how long you’ve been diabetic - and sometimes after a long while the pancreas just “wears out” and doesn’t produce enough after years of overcompensating for the high sugars and insulin resistance or it was never type 2 in the first place and was in fact LADA.
 

What you are experiencing, miffli, is ketosis NOT ketoacidosis. Ketoacidosis only occurs when blood sugar (glucose) levels are very high, whereas ketosis occurs because your body is 'burning up' fat instead of utilising glucose from your bloodstream. Ketosis is often identified in people that are starving or are partaking in extreme dieting. The symptoms are very similar in that fat is being 'burned up' as a source of fuel, with the resultant 'pear drops' smell about their breath, but the BIG difference is blood sugar (glucose) levels. Ketoacidosis is a life-threatening condition which would need you to be admitted to hospital for emergency medical attention. With ketosis they'd simply advise you to eat.
 
lcarter said:
I was just going to mention this. My levels are in the 8-13 range but I'm only on day 3. Will this stabilise do you think, from your personal experience?
Click to expand...

Great question @lcarter.

I dug out my old log book where I graphed my glucose levels for the first 8 or 9 weeks on the keto diet, eating 30 - 42 g carbohydrates a day, and I began walking. I do not take any medications for diabetes or any other chronic health conditions. Never have, hopefully never will. In the beginning I could only walk short distances, and I couldn't walk straight. I kind of weaved my way up the gradual rise of our hill. Months would pass of walking daily until I was able to walk 3 miles for the first time. Today, walking 3 miles is easy for me...

The first week, toward the end of February 2015 - (Note: I often had to round up or down from mg/dL (US) to mmol/L (UK) using the "50 Shades of Diabetes" chart here on diabetes.co.uk)...

Day 1 - 245/13.3 252/14.1 239/13.3 217/11.7
Day 2 - 228/12.5 226/12.5 251/14.1 190/10.5 276/15.3 257/14.1
Day 3 - 213/11.7 188/10.5 297/16.5
Day 4 - 213/11.7 195/10.8 182/10.1 227/12.5
Day 5 - 192/10.6 187/10.3 179/10.0
Day 6 - 179/10.0 170/7.8 148/8.2
Day 7 - 174/9.7 145/8.1 148/8.2

Weekly average for first nine weeks...

Week 1 - 210/11.6
Week 2 - 168/9.4
Week 3 - 169/9.4
Week 4 - 149/8.2
Week 5 - 134/7.5
Week 6 - 139/7.8
Week 7 - 129/7.1
Week 8 - 131/7.3
Week 9 - 128/7.1

And here's what my glucose levels were for a week, end of April, beginning of May 2016...

Day 1 - 129/7.1 89/>5.4
Day 2 - 101/5.6 139/7.8 109/6.0 95/>5.4 98/5.4 125/7.0 111/6.2
Day 3 - 96/>5.4 104/5.7 134/7.5 91/>5.4 134/7.5
Day 4 - 93/>5.4 121/6.7 157/8.7 106/5.9
Day 5 - 101/5.6 118/6.5 118/6.5 136/7.6 108/6.0 123/6.8
Day 6 - 102/ 80/>5.4 88/>5.4 103/5.7
Day 7 - 91/>5.4 123/ 97/5.4 109/6.0

My average glucose level for that week was 110/6.0, so as you can see, there was further improvement over the next year. At that time I was still following a strict keto diet, eating real, whole foods. No processed foods. And I was walking daily, or every other day. No medication...ever.
 
Last edited:

I thought that was true too until I learned that there have been a few cases of ketoacidosis reported with specific diabetes medications in type 2 diabetics. That's likely why miffli's doctor took her off the medication immediately. I don't know if miffli is in ketosis yet.
 
Is this for me?

Yes, my dr took me off jardiance because ketoacidosis is a known side effect.
 
@Winnie53

How helpful is this? Thank you so so much. Out of interest, what would a days food look like for you? I'm struggling! Thankyou again x
 

I had said somewhere when i first joined regards when i was diagnosed but cant find my first threads, it is some 6 years now since first diagnosis and i managed on diet alone for perhaps 3 i think, then i was put on metformin and gliclizide, both of which affected me in a bad way, thing is they were treating me for high hba1c without realising at the time i was suffering from Lymphoma so when i had radiotherapy that took me high for quite some time too, it is only recently that I have managed to get my sugars down.

Yes i have had other functions tested only i have a full screen every 3 months since the Lymphoma, my last i believe is March. I also take multivits for iron and what have you only because of the lethargy i have suffered from since finishing the radiotherapy.

tonight i was 9.2 before dinner and 2 hours after 12. 5 .. i feel like a balloon, all pumped up with taught skin.
 
No @lcarter I was repsonding to the poster. That said, miffli actually had a bit of a scare when she first started the keto diet. Thankfully, she was taken off her medication as soon as her doctor realized she was having problems. Glad you're doctor took you off Jardiance before starting keto. I love hearing positive stories like that!
 
@miffli I'm concerned about that leg swelling. And thank you for sharing that you had lymphoma and are being followed for it. I need to learn more about that condition. Is leg swelling normal for your history of lymphoma? I hope you'll call your doctor if you haven't already.
 

Yes i am still on their list for check ups, no, it isn't normal for me, only today, both my legs feel like I have bad water retention and i'm excuse, peeing for England.
 
Oh dear you have had a rough time. I couldn’t find anything on this post or your profile about diagnosis hence asking. I’m wondering how much the lymphoma and treatment for that has affected your levels and your bodies ability to manage carbs. I have no experience of these issues.
Good to hear other possible causes have been investigated. Not all supplements are equal btw some are far more effective than others.

So all things considered, the other symptoms have calmed down? And the tiredness may well be related to the radiotherapy? And other causes of the tiredness have been explored? And you’ve been diagnosed long enough that misdiagnosis of LADA is less likely.

I think you are now dealing with a noticeable dawn phenomenon which will come down eventually if the rest of the day remains in good control. It’s usually the last piece of the puzzle to fall into place but the first relied upon.

What was dinner? A rise of over 3mmol isn’t the best.
 

I think a year before I was diagnosed with Lymphoma i was rushed into hospital with suspected ketacidosis and hence why i worry, i remember i was grey and stark and i felt really rough, i was extremely rude and antisocial, when i got into the hospital i collapsed and they didn't have anything that could measure my sugar levels, after 2 days of an insulin drip in my arm they managed to measure me ' 58mmol so was going down, the day after i was in my 20's and went home the day after that. I was given the metformin and gliclizide first and then some time after went on to insulin but i threw a wobbly and got off it because it wasn't really doing anything, I started the Empagliflozin and within a few days my sugars went flying down to reasonable levels and were ok for a while but I had constant uti's.

So then i started this keto just before Christmas and my sugars are still all over the place but when I was on the empagliflozin and keto i was getting readings of 4, which was the first time since the ketacidosis scare.

Dinner was stir fry which i don't have that often, Albacore tuna, pak choi, spring onions, fennel, a small amount of chorizo niblets, bean sprouts, aubergine and courgette and that was it... i'm still absolutely starving lol.
 
I have to now admit I’m baffled and way above my pay grade lol.

A hospital couldn’t measure your bgl for 2 days !?? It was 58mmol? I’ve never heard of one that high. Perhaps that’s why they could measure it. I think most meters top out in the 30’s.

dinner sounds good other than I see no fats to keep you feeling full.

I think in your shoes, should these high numbers continue without signs of improvement, I’d be wanting to know what my pancreas was capable of producing before making further choices. Maybe something in the lymphoma treatment is now effecting your ability to make insulin (wild guesses here so don’t panic).
 

Yes, honestly, I was delirious but could understand, they tried to put me in a ward where people were dying, spending their last moments or what have you, there was an argument as the ward sister said she isn't dying and get her out of here.. i was left outside in the corridor for hours! then they took me somewhere else and i could hear the rain on the roof, it was quite comforting, they put me on a drip but categorically stated that they had no equipment to measure as it was supposedly showing error. The nurse mentioned to me a couple of days later at least they can now read my sugar levels so it was all good and she showed me, here look, 58. You are as baffled as me. My Hba1c had been over 100-110 for about a year, also supposedly bad.

I didn't have any pudding tonight - vanilla flavoured keto toast with cream, i sprinkle it with almond flakes, it's ok, it isn't cornish ice cream.. my old favourite.. if only.

I'm not sure but i was given the all clear, i am in full remission thankfully but i have never been quite the same since so i'm not sure what, i guess i'm lucky to be here..
 
@miffli I could be wrong, but I don't think the leg swelling is directly related to your diabetes or keto diet. Your "peeing for England" comment through funny brought back three memories for me...

The morning my son was born, via an unplanned c-section, I developed pre-eclampsia and began swelling while still in the hospital. My gynecologist explained that my blood platelets had dropped significantly, and that it was important to not scratch or use sharp objects such as a razor because if I started bleeding, it would be difficult to stop the bleeding. Then, lucky for me, the edema began reversing and they didn't have to call in that specialist after all. I don't think I've ever peed so much, before or since.

Edema can be due to a lot of things, such as a simple vitamin deficiency in my case. I had edema off and on in my ankles for 10 years and the doctors couldn't figure out why. One day, I was reading a book on functional medicine, and I came upon the solution. And happily, I tried it and it worked. But, in my diabetic friend's case, her edema was due to the development of chronic kidney disease, and she ended up in the hospital three times in one year due to hypertension and edema. One time she even got an ambulance ride. (I've done that before too, not fun at all).

What's happening to you may be transient, but I'd feel a lot better if your doctor ordered some lab work for you.
 
Miffli, the down side of facilitating a diabetes group is hearing hospital stories like yours, though they're not usually that scary...yikes! And it's stories like yours that keep me so motivated to keep my diabetes well controlled.

If you look at the glucose levels I posted here today, you'll see that they ran high for a while too, but that was with no fruit, no berries, no sugar, no sweeteners. Meat, cheese, butter, eggs, raw nuts, non-starchy veggies, and leafy greens, avocados, green olives, and a variety of fats and oils only. The sweetest thing I ate was a quarter of a carrot on my salad for lunch in the early days of the my keto diet.

Four years earlier I'd come off all wheat, rye, and barley after being diagnosed with non-celiac gluten sensitivity (and I loved baking!). After two weeks of withdrawal symptoms, I called the facilitator of the local gluten-free group and she hooked me up with gluten-free baker. Once a week I could get freshly baked, gluten-free bread, rolls, cakes, and cookies again. And the withdrawal symptoms stopped. It probably was partly from coming off the grains, but more probably in larger part due to coming off the sugar.

When I started the keto diet, I went through withdrawal from sugar all over again, but this time I knew I could push through it if I just stuck it out for two to three weeks. That said, I'm not perfect. What I finally settled on was a box of frozen, gluten-free, peanut butter cookies that came 9 to a box. When the cravings became so bad for something, anything that tasted sweet, I'd get one of those cookies out of the freezer and eat it frozen. By the end of the nine weeks, I'd purchased a total of two boxes of those cookies and still had a few cookies left, which I finally threw in the trash months later uneaten.

I had other ways of countering the intense cravings for "sweet": garlic dill pickles, by themselves, or rolled up with a slice of ham, and a slice of cheese or a chunk of cream cheese. Delicious. Journalist Nina Teicholz, author of the ground breaking book, The Big Fat Surprise (2014), still has cravings for sweet sometimes. To counter it, she eats some fat instead. And that works for her. I've done that with a pat of butter for years.

You don't know how good real food tastes until you've completely given up "sweet" for a period of time. I don't know how else to explain it. It's something that you have to experience to understand.

You're doing a lot right with your diet. It's a big change, I know, but it's so worth it in the long run.
 
12.5 after dinner tonight, that was quite some time ago, i can't sleep and am on 13.9, i have had nothing since dinner except two mugs of tea and nearly a litre of water, i'm tempted to take some meds but worried either way, it's not like i can call up my gp in the morning and get an appointment, it would be next week regardless :|

This Kidney disease thing worries me too though it isn't just my ankles, it is all my legs right up to my thighs and i did have pains in my lower back today quite a few times, a deep throbbing pain.

Also, i might stop taking the potassium tablets only because of taking the perindropril this could be an issue
https://www.healthline.com/health/perindopril-oral-tablet#about
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…