Worried about ketoacidosis

@lcarter I can't talk keto diet specifics with you on this thread but I can if you start your own thread or if you PM me.

That's a very interesting link miffli. I don't know how things work in the UK, but I think you need to call your doctor's office in the morning to tell them about the leg swelling, also that you read an article stating to "Call your doctor right away if you have"..."swelling of your face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs" with the medication they have you on.

miffli, if you're beginning to have kidney problems, I've got your back. Because of what my friend is going through, I can give you access to excellent resources that will get you off to a strong start. Conditions like chronic kidney disease in the early stages can be managed with diet alone just like diabetes. That said, I've had kidney pain off and on throughout my life. Kidney pain sometimes is transient. I experienced that briefly when I started the keto diet. It turned out to be transient and resolved quickly on its own.

I'm glad you're taking the leg swelling seriously.

Am flabbergasted. Is this normal for where you live?

@miffli, perhaps the weight gain is due to the swelling in your legs?

I'm saddened to learn that your access to appropriate healthcare is so limited. Your experience with getting your glucose levels back down mirror mine in 2015 in that they are continuing to run high for weeks which is frustrating and troubling, but you're dealing with two additional challenges: 1) coping with the effects of coming off your first medication and 2) a possible adverse effect from your second medication, a question that's unanswered for now.

How are you doing today? Are you better? worse? the same?

miffli said:

Woke up within the last half an hour and am on 17.3 which is the highest I have been since changing diet, i really thought i was winning when i was taking the meds due to getting readings like 4, i'm surprised just how much the Empagliflozin actually does.

I had gone 18 hours fasting and then got home, had dinner which was a carnivore thing, bacon, meat etc with some eggs and then almond pudding with cream.... i'm wondering if the almond / keto toast pud thing is taking me up to those levels or is it the phenomenon again?

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What were your readings before and after the pudding? What exactly is in it? My radar pings as soon as someone says toast

miffli said:

Woke up within the last half an hour and am on 17.3 which is the highest I have been since changing diet, i really thought i was winning when i was taking the meds due to getting readings like 4, i'm surprised just how much the Empagliflozin actually does.

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This is why I am so resistant to taking any diabetes medication: Your glucose levels and A1c may be fine but you don't know what's happening with your insulin resistance unless you're also checking your fasting insulin level and know your fatty liver status.

Looking back at my glucose reading log in 2015, my glucose level peaked at 297 mg/dL/16.5 mmol/L the evening of the 3rd day of eating 30 to 42 carbs a day.

I too would like to know what exactly is in your keto toast and almond pudding. Either the recipe ingredients and amounts or the nutrition label information.

@miffli I don't think you're stupid, nor do I think I am stupid. On the other hand, there is a lot of helpful as well as bad, just plain wrong, information online, also on television, and in print.

My glucose levels ran high initally in 2015 for weeks despite eating all the right foods. The only thing I know to do in these circumstances is to continue monitoring, stay the course, consult your doctor as needed, and continue riding out the storm.

It's frustrating. I vented a lot during those early weeks.

My friend who has had diabetes for 20+ years called me last night. She's the one who developed high blood pressure followed by edema in her legs, followed by three hospitalizations in a year's time.

For her leg swelling, initially she was instructed to limit water intake to 47 ounces a day, to elevate her legs above her heart when laying down or sleeping, and to flex her feet periodically.

She also is hopeful you'll be able to see your doctor soon to determine the cause of your leg swelling. When I developed swelling in my feet and ankles, my doctor ordered lab work and an ultrasound.

It's good to have another update from you @miffli Please keep them coming!

I have no idea what their response "it's to be expected" means. Do you?

I suppose you have three options:

1) Wait until your appointment next week.

2) Contact your pharmacist to ask why does this medication cause leg swelling? What are the risks of continuing on it for another week? What are the risks of discontinuing it now?

3) Call your doctor's office back to say, "When I informed your office that my legs are swelling, and that I read I should inform my doctor if this happens on the medication he prescribed for me, I was told by your office "it's to be expected". I'm really confused. I've never had leg swelling before. Why is leg swelling to be expected? If the medication he prescribed for me is the cause of my legs swelling, shouldn't I stop taking it?"

Honestly, I'm as stumped as you are. I've never experienced this before. When I ask a question, I've always gotten an answer from my doctors. Or a nurse has answered my question or consulted my doctor and gotten back to me.

Your glucose level of 12.9 mmol/L/(233 mg/dL) a few hours after dinner is encouraging. That's a significant improvement and suggests to me that your fasting insulin level is finally beginning to come down, also that you're fatty liver is getting better. That's good news!

I anticipate your glucose levels will continue to run high for another two weeks. I know that feels scary and discouraging. Keep in mind that it took a long time for your insulin resistance to worsen to this point, but incredibly, your body IS responding to all your proactive efforts, and you're making progress! You're heading in the right direction!

Yay miffli!

miffli said:

I thought it would be stupid if i ate normal bread or any carbs like those and especially right now, i'm still worried about the level of sugars with this keto, 12.9 a couple of hours after dinner tonight, even though I have read what others bs were like, it is the jump off the jardiance and seeing things seemingly going downhill. (i'm hoping anyone did not take my notes above personal!)

I can't seem to get an appointment until next week, i've said my legs are swollen and told them what i'm doing and they say 'it's to be expected' it is just my legs, nothing else, from thighs to ankles but my thighs feel taught.. i had stomach ache earlier too and acidic sick, kind of worse than reflux. I do feel better when i lay down though with my legs up like has been mentioned. Anyway, I really do appreciate everyones input, help and advice here, i am sure i would be totally lost without you all x

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With my GP, you can ask for a callback from the doctor rather than an appointment. If I have asked these are always the same day, often when there's a gap when someone fails to show or around 11am after morning surgery.
In the past, I have also used this to ask my GP whether I need to make an appointment to see them.
Winnie53's suggestion of speaking to your pharmacist sounds a particularly good alternative approach.
We're behind you!

miffli said:

Like @lcarter my morning readings are getting high again, today is 15 though my leg swelling has just disappeared?! It must just be fluid retention i guess, never know anything like to to just go.

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Not that I’m suggesting 15 is desirable but morning readings are typically the highest of the day once eating the right foods due to dawn phenomenon. It can take months and months for them to reach good levels (but improving along the way though). How is the rest of the day going ?
Good news the legs are back to normal