Ketones advice please!

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SarrieP

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Type 2
Afternoon. I'm T2 and was diagnosed with shingles 2 weeks ago. I've been feeling tired, generally unwell and was sick yesterday. The doctor checked my urine and found ketones. His advice was to drink more and not just water- to drink more sugary drinks which I avoid as I'm T2. He said the ketone reading was 4. I've come away feeling a bit confused and have tried to find out more online but I'm no clearer! Can anyone give me advice on this? Thank you.
 
What medication are you on @SarrieP ? What’s your blood sugar? And have you been eating normally? Some ketones will appear if you haven’t been eating and they’re generally harmless, but occasionally Type 2s can get high ketones and be at risk of DKA so it’s always sensible to be aware of them.
 
Thanks for your reply. I'm on Synjardy 2x a day and Trulicity injections once a week. I've never had a problem with ketones before I don't think. I was a bit confused with the doc telling me I needed to drink more than just plain water. I don't check bloods regularly but they were 10.4 today about an hour after food. I've ordered some ketone test strips (urine) to keep an eye on them but I'm not really sure what I'm looking for and what to be worried about.
 
I eating but not as much as usual as I've been completely wiped out by what I think is the after effects of shingles- total exhaustion and I was sick yesterday.
 
Tagging @Lucyr as she’s Type 2 and has had ketoacidosis. I think the medication you’re on can cause issues with ketones.
 
Synjardy is empagliflozin. It’s important not to go low carb on this medication so if being ill has meant you’ve not eaten as much as usual that will be why your doctor has said to have some sugary drinks to get rid of the ketones. You can go into DKA at normal bg levels on this medication so it’s important to check ketone levels when unwell and seek urgent medical help if the ketones don’t reduce or you feel more symptoms of dka
 
Inka said:
Tagging @Lucyr as she’s Type 2 and has had ketoacidosis. I think the medication you’re on can cause issues with ketones.
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Was typing as you did!

I had DKA whilst taking empagliflozin, look up the symptoms of DKA and if you get any of them eg start being sick again it absolutely wouldn’t be an overreaction to go to A&E, taking the box and leaflet with you, and ask them to check blood ketones.

I had to stop taking them because they gave me DKA and once I stopped the ketones cleared within a few days. Pharmacists and 111 can also help advise out of hours if you’re unsure or concerned about your symptoms.
 
Thanks for this. I was not aware of that. What would be considered an abnormal ketone reading? It's not easy to find this info online. I have ordered strips so I can keep an eye on this myself.
 
And am I OK to check keytones with the urine test as I don't have a ketone reader/strips.
 
SarrieP said:
And am I OK to check keytones with the urine test as I don't have a ketone reader/strips.
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Yes. The urine sticks aren’t as accurate but they’ll do. I have only urine sticks.
 
SarrieP said:
Thanks for this. I was not aware of that. What would be considered an abnormal ketone reading? It's not easy to find this info online. I have ordered strips so I can keep an eye on this myself.
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The information online is generally for ketones in the blood rather than urine, and, yes, it can be confusing. If you have Ketostix (urine sticks), there’s a colour scale on the side. I think your situation is somewhat complicated by the fact your medication can cause ketoacidosis. Better safe than sorry so if in any doubt whatsoever, seek medical advice. Ketoacidosis is potentially serious.
 
Thanks so much. I have read the info on Synjardy and will keep a close eye on my ketones once the sticks are delivered tomorrow. Thanks Inka and Lucyr - I've had better info from you both than I've been able to find anywhere.
 
Don’t be afraid to phone 111 for advice if you feel unwell. Do drink the sugary Coke as well, as your GP advised. If you suspect DKA, you need immediate medical attention so A&E is the place to go.
 
These are the DKA symptoms:

What are the signs and symptoms of DKA?​

The signs of DKA include:

  • high blood sugar levels
  • being very thirsty
  • needing to pee more often
  • feeling tired and sleepy
  • confusion
  • blurred vision
  • stomach pain
  • feeling or being sick
  • sweet or fruity-smelling breath (like nail polish remover or pear drop sweets)
  • passing out.
 
I just had dka was picked up by my gp I a reading over 10.I home now from Hospital after 5 days.could be 1.5 as well have to wait for tests to come out.
 
Sorry to hear about your ketones @SarrieP

Look after yourself, and do call NHS111 or go to A&E if you get symptoms from your ketones - DKA, isn’t something to mess with 😱
 
If your sugars levels are over 16 your more likely to have higher DKA
 
Totalwar said:
If your sugars levels are over 16 your more likely to have higher DKA
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Not sure if you’ve read the thread but the OP is on empagliflozin, one of the potential side effects of that is DKA with normal blood sugars, they don’t need to be high to get DKA especially on this medication.
 
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