Couple of questions:

[Jimmy2202]

Evening all.

Couple of things I’m trying to get my head around.

Should I be testing for ketones when levels above say 14 even when i know it’s down to food spikes (and not injecting enough bolus)?

Does food like peanut butter (high in protein and fat) digest slower than other foods creating a later spike like pizzas?


Cheers

 

[DaveB]

Personally I wouldn't bother unless you have experienced high ketones before. Whenever I have tested with high BS my ketones are always virtually zero.

 

[Sally71]

All foods digest at different rates, and a high fat content in your diet definitely slows down digestion, so I can’t comment specifically on peanut butter but it’s definitely possible that what you’ve eaten might spike later than expected.

As for ketones... I really don’t see the point of checking for them every time you get a reading above 14, especially if you know the likely cause and if the BG comes down again quickly. The strips are so expensive and it just seems like a waste!

The only times I would ever think of checking for them are if you’ve got a tummy bug or something and can’t eat much (in which case they will be raised a bit due to starvation) or if you have had sustained high blood sugars which won’t come down for some reason (high teens and above).

The only time my daughter has ever had raised ketones was when she had a tummy bug once and was hardly eating anything at all, ketones went up to 1.5 which is apparently just about OK as long as BG isn’t high as well, which it wasn’t; and a couple of times when we were having problems with pump tubing and cannula and the insulin wasn’t getting in properly, they went up to about 4 then! But came back down again as soon as the problem was resolved. The last time her cannula fell off in the night and she didn’t realise the ketones were only 0.9 the next morning, I was expecting them to be higher!

All of which isn’t going to happen to you if you’re not on a pump of course 🙂

 

[helli]

I agree with @Sally71 I would not be testing ketones every time I go over 14, especially if you know why.
I use ketone tests when I have a prolonged high which I find hard to explain and doesn't seem to want to come down.

However, if you are getting a lot of spikes over 14, you may want to look at pre-bolusing a little earlier, especially with food that is digested quickly such as rice or sweet foods without fat. Food such as pizza (and maybe something with peanut butter) may need a later pre-bolus.

 

[leonS]

It is not the high BG that causes the problem as the lack of insulin. If you have a spike you are not short of insulin given that BG comes down in a reasonable time.

A spike is very different to a persistant high

I was advised to test only if it remained high for more than 4 hours and this advice is very cautious.