advice needed please

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CharlotteScr said:
Thanks @Robert459 that's very interesting. Absolutely take your note of caution. Very useful to hear your experience and I am coming to that conclusion as well. I just want her to feel well, so will focus on that not get preoccupied with ketones while her BG is so well controlled
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@CharlotteScr It is possible to get ketoacidosis with normal blood sugar. It’s called euglycaemic ketoacidosis. Low levels of starvation ketones are ok, but with higher levels something like illness can push you into DKA.
 
Robert459 said:
Maybe, as long as her BG level is good, forget about the ketones ?
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Well that’s dangerous advice. I’ve had DKA with normal bgs.

Always pay attention to ketones when feeling unwell, regardless of your bg level.
 
Inka said:
@CharlotteScr It is possible to get ketoacidosis with normal blood sugar. It’s called euglycaemic ketoacidosis. Low levels of starvation ketones are ok, but with higher levels something like illness can push you into DKA.
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Many thanks @Inka I found this quite helpful https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107974/ in explaining euglycemic diabetic ketoacidosis. Based on this, i can imagine that the not-eating/nausea caused by the anxiety, and then continued by the raised ketones, could in theory bring on euglycemic DKA. Every day something new with diabetes....to listen to the news, you'd think everyone on a closed loop was totally cured and carefree....o_O
The good news is that her ketones are back down to normal levels and she's feeling much better- we think through a combination of exercise, drinking masses of water and eating whatever she could manage. So many thanks for all your advice!
 
Good news @CharlotteScr I know it sounds counterproductive when she’s feeling nauseous but some carbs can actually help the nausea, and the starvation ketones too.

I hope she can improve the anxiety. It’s a horrible thing. I find Mindfulness very good. Even deep breathing can be calming and really effective in reducing the anxious feelings.
 
Just wanted to reply to everyone here with a quick update on anti-nausea : daughter recently had her 4 wisdom teeth out under general anaesthetic and surprise surprise, 24 hours after discharge starting vomiting continuously and ketones through the roof despite low BG. Ended up in A and E as they thought she might have an infection (she didn't) but got IV Zofran (ondansetron) and cyclizine tabs to control the vomiting. Sadly the cyclizine didn't work, but the Zofran was instant, and we managed to get a prescription for a few Zofran melts which also seemed to do the trick. I don't know whether it's a long term strategy as the NHS is not keen on handing out Zofran..... but at least good to know something helped and might do next time. Thanks again for all your help. I will ask the diabetes team next week for their advice and reply if they say anything different, fwiw
 
Sorry to hear you had the stress of an A&E visit @CharlotteScr but at least you’ve found something that works for the vomiting. I wonder if there’s actually a digestive reason involved too, eg excess acid or poor microbiome, or even an ear/balance thing.
 
Inka said:
Sorry to hear you had the stress of an A&E visit @CharlotteScr but at least you’ve found something that works for the vomiting. I wonder if there’s actually a digestive reason involved too, eg excess acid or poor microbiome, or even an ear/balance thing.
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Thank you 🙂I hadn't thought of that....i guess there could be? i am in the habit of blaming diabetes for everything!- but i guess that's how the other big things get missed
 
CharlotteScr said:
Thank you 🙂I hadn't thought of that....i guess there could be? i am in the habit of blaming diabetes for everything!- but i guess that's how the other big things get missed
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If it was me, I’d get some investigations done. Don’t mention the anxiety at all or downplay it as otherwise they’ll just say it’s that, especially as she’s female (yes, sexism lives on in the NHS 🙄 )
 
Inka said:
If it was me, I’d get some investigations done. Don’t mention the anxiety at all or downplay it as otherwise they’ll just say it’s that, especially as she’s female (yes, sexism lives on in the NHS 🙄 )
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Oh yes- good advice. It seems like we move from 'anxious teenage girl' to 'neurotic menopausal woman' in the blink of an eye..!! I suppose there might be 2 or 3 months in your early 30s when you're considered as sane as a male peer, but that's it :rofl:
 
CharlotteScr said:
Oh yes- good advice. It seems like we move from 'anxious teenage girl' to 'neurotic menopausal woman' in the blink of an eye..!! I suppose there might be 2 or 3 months in your early 30s when you're considered as sane as a male peer, but that's it :rofl:
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Unless, of course you are pregnant and can end up lying on a table with people talking over you.
 
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