High BG & Low level ketones

[ch1ps]

I was 21 after lunch with low level ketones. I have taken 8 units of novorapid and am now at 15.8 still with low level ketones. I've been trying to drink a lot of water (not sure if that's what I should be doing?).

Any other tips? I'm worried about the ketones although they are low at the moment.

 

[novorapidboi26]

What your doing is great..........

Keep hydrated to help with getting rid of the excess blood sugar and allow your correction to kick in........

At levels of above 20 its likely the normal correction factors may not work, so you might not get on target with that 8, but you can catch the rest at the next meal........

 

[Northerner]

I don't think you need to worry about the ketones as they are low and your levels are coming down 🙂 Are you feeling poorly at all? How long after lunch were you at 21? Do you think it was a mealtime miscalculation?

 

[ch1ps]

Thank you for the replies.

I've been silly as my GP has put me on once a day novorapid, hence rising BG, nothing to combat dinner & breakfast, just take at lunch a set amount regardless of what I have eaten.

I woke up +13 this morning, I know I should have taken some to cover breakfast & didn't because I'm doing what GP said - bad move.

So I'm going to have to take my novorapid with every meal and if he moans then tough for him.

I've been trying to work out what my basal should be but I just don't understand it, I'm not sure about skipping meals etc to do the testing.

 

[Northerner]

Thank you for the replies.

I've been silly as my GP has put me on once a day novorapid, hence rising BG, nothing to combat dinner & breakfast, just take at lunch a set amount regardless of what I have eaten.

I woke up +13 this morning, I know I should have taken some to cover breakfast & didn't because I'm doing what GP said - bad move.

So I'm going to have to take my novorapid with every meal and if he moans then tough for him.

I've been trying to work out what my basal should be but I just don't understand it, I'm not sure about skipping meals etc to do the testing.

That seems like very poor advice At the very least you need some NR to help bring down your waking levels. What were you before bed? Depending on how much your waking level differed from your bedtime level it might be a problem with your basal - ideally they should only differ by 1 or mmol/l (ideally, not easy in reality!). Having one fixed dose at lunchtime regardless of levels and food eaten strikes me as making no sense at all 😱 What if you were on the low side and had scrambled eggs? Instant hypo! Or if you were high (as you were) and didn't take enough to cover your lunch, let alone your evening meal? I'd like to know where he got such a notion from that this would generally work, I would expect it to generally fail. I'd get another doctor, a DSN or a consultant if I was you.

 

[ch1ps]

I was quite high before bed last night. It's my fault I know in my mind what I should do, but I was doing what Dr said.

I agree the set lunchtime dose is silly on it's own as you said what if I ate no carbs?

I have to go back next Monday and I going to ask to see a consultant, my GP is the diabetes specialist for the surgery, but clearly he doesn't know enough. Scary, because I certainly won't be the only diabetic in the surgery 🙄

 

[Northerner]

I was quite high before bed last night. It's my fault I know in my mind what I should do, but I was doing what Dr said.

I agree the set lunchtime dose is silly on it's own as you said what if I ate no carbs?

I have to go back next Monday and I going to ask to see a consultant, my GP is the diabetes specialist for the surgery, but clearly he doesn't know enough. Scary, because I certainly won't be the only diabetic in the surgery 🙄

I've encountered a couple of these GPSIs (GP with Special Interest), and they are usually only used to dealing with Type 2 cases, who, even if they are on insulin might be on a mixed or just a basal insulin - makes sense, because Type 1 (or 1.5) is relatively rare, so they won't encounter many. It does mean that their knowledge is often limited though. Get someone with specialist expertise, not a generalist with a 'special interest' 🙂

 

[heasandford]

I spent a long time trying to do what the doctor and local DSN suggested, I know they are following probably 'statistically' correct procedures, but individual cases vary dramatically.

Despite thinking I am a reasonably intelligent person, like you, it was hard to challenge or completely ignore what the doctor says, so don't beat yourself up too much! Isn't it great to come on here and get more opinions and help!

 

[ch1ps]

I've encountered a couple of these GPSIs (GP with Special Interest), and they are usually only used to dealing with Type 2 cases, who, even if they are on insulin might be on a mixed or just a basal insulin - makes sense, because Type 1 (or 1.5) is relatively rare, so they won't encounter many. It does mean that their knowledge is often limited though. Get someone with specialist expertise, not a generalist with a 'special interest' 🙂

I think I am learning the above the hard way, GP trots out the line he's a specialist. However you have outlined it correctly.

 

[ch1ps]

I spent a long time trying to do what the doctor and local DSN suggested, I know they are following probably 'statistically' correct procedures, but individual cases vary dramatically.

Despite thinking I am a reasonably intelligent person, like you, it was hard to challenge or completely ignore what the doctor says, so don't beat yourself up too much! Isn't it great to come on here and get more opinions and help!

Yes, I believe that has been my problem that I feel I should do what the Dr says. However, in this case his advice has not been the best. I certainly do not want to wind up in hospital due to high ketones.

 

[DeusXM]

ch1ps - I know it must feel pretty sucky at the moment but I just want to to say 'wow' about how quickly you're picking this up. You totally get how to use Novorapid and why, despite the c**p info your doc has given you. It can take some people YEARS to get the hang of this stuff. Keep at it, something tells me you're going to be one of the ones with a fantastic A1C in a pretty short time.

 

[ch1ps]

ch1ps - I know it must feel pretty sucky at the moment but I just want to to say 'wow' about how quickly you're picking this up. You totally get how to use Novorapid and why, despite the c**p info your doc has given you. It can take some people YEARS to get the hang of this stuff. Keep at it, something tells me you're going to be one of the ones with a fantastic A1C in a pretty short time.

Thanks DeusXM,

I am trying to get this sorted, I know this is with me for life and I want to stay well to prevent complications further down the line.

I was worried when I first went on insulin as I imagine everyone is. However I got passed the fear bit quite quickly (thankfully).

My last A1C was still quite high, but was an improvement from when I was hospitalised when my BG went off the meter at the walk in clinic. So it's definitely working.

Going to have to get a referral to consultant though via GP. I don't think my PCT does DAFNE though

 

[DeusXM]

Look on the positive side - you don't need to go on a DAFNE course to adjust your insulin intake. I've never been on one, although I once did two mornings of carb counting with my hospital where they taught the vital knowledge that the about of carbs in a food item will be marked on the packet under 'carbohydrates'. I adjust my insulin based on my own reading - you can work out your ratios reasonably easy (work from 1:10 and then adjust in 2.5g increments, assuming your basal is accurate). You can do this!

 

[ch1ps]

Yes, my basal is not right just yet & I'm not really understanding how to get it right. Have read two articles that other members have kindly posted, but worry about the skipping meals and then testing etc.

Is there an easy way to do it?

 

[Northerner]

Yes, my basal is not right just yet & I'm not really understanding how to get it right. Have read two articles that other members have kindly posted, but worry about the skipping meals and then testing etc.

Is there an easy way to do it?

Why are you worried about skipping meals? If you are not eating then you will not need to inject the novorapid. I'm afraid it's the only way to test basal.

 

[ch1ps]

Why are you worried about skipping meals? If you are not eating then you will not need to inject the novorapid. I'm afraid it's the only way to test basal.

I'm worried as I don't know when I am allowed to eat after the test & the exact process. I don't want to go through till say noon with no food not worried about the BG etc.

I might have to wait till next weekend as during work it'll be too stressful.

Once I have the process clear in my mind I will do it.