High ketones / Low blood sugar -- is this possible?

[Amity Island]

Hi Everyone,

I am just picking up on the recent post about high ketones and what to do if you've only got one ketone test strip left.

If one has high ketones confirmed with a ketone test meter (and you are still feeling ok) and then you make a correction dose (+the additional 20% of t.d.d or so) then provided you get your blood sugars back down, then ketones levels will come down too?

It only takes one ketone test to determine that you need to add in extra insulin on top of the normal correction.

Are these correct assumptions everyone? That provided you deal with getting blood sugars back into safe range, then Ketones will automatically disappear? and hence not having any more ketone test strips wouldn't be a problem as you wouldn't need to do another ketone test.

Thanks​

 

[Sally71]

Usually that's what happens, and certainly always in my experience; high ketones are dangerous though so it's always comforting to KNOW that they have come down again, and I think there are also circumstances where it is possible to have high ketone levels with normal blood sugar. (I can never remember what those circumstances are though!)

Deciding how many ketone strips to keep in is tricky, you don't want to overstock because you don't need them very often and they have a short shelf life and they'll be past their use by date before you need them, you need some for emergencies though as you can quite easily use up a whole packet on one sickness bug! I usually try to have one whole packet in plus the in use one, never more than that though.

 

[everydayupsanddowns]

Would/could ketones alongside non-elevated BG be dietary/fasting ketones?

My understanding was that it was ketones in the presence of high BG (and related to absolute insulin deficiency) which were the problem?

 

[Lisa66]

That’s my understanding to Mike.

A couple of years ago I was being sick, highest bg was 11...ketones on the ketostix read as dark as they go. So off to A&E. They were brilliant, whisked me through, day of tests, extra fluids etc, then at about 8pm, a junior dr asked if I’d had anything to eat all day, I hadn’t. He came back with a cheese sandwich and sent me home to monitor, certain that by the time I got home the ketones would be coming down. They did, back to normal by midnight. As I obviously hadn’t tested for ketones before being sick, I wasn’t sure in the morning, which had come first.

We were away on a city break the following weekend, lots of walking, brilliant bgs, but because I was now a little preoccupied with ketones I did test when we got back to hotel before dinner each day...ketones were present, although not high. After dinner back to normal. I asked at next appointment and dr explained that doing the extra exercise with no extra snacks, meant my body was searching for energy elsewhere, hence the cause of ketones.

My first, and hopefully last, issue with ketones....still scary though, at the time not knowing the reason.

 

[trophywench]

I work on the basis that when I get a rogue high and the meter says test ketones, if I then discover it's because I didn't bolus for my last meal (which of course my pump will tell me NP, not so easy on MDI) then obviously I immediately take whatever correction dose I need for the actual BG now, BUT rarely think about testing ketones because as you say as long as the BG reduces asap then any I have will dissipate as I visit the loo thereafter.

However when you are actually ill or eg when I broke my knee so there was pain and inflammation affecting my BG and causing mega high ketones - because it's unpredictable how long or how much, you have to keep testing both BG and K to see if your guesswork on how much to increase insulin by, is working.