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Ketones
- Thread starter Liz!
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Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
If your blood sugar doesn't go down, perhaps because you've got a possibly unapparent infection, then the ketones will rise and rise, raising the acidity of your blood and leading to DKA. You should always check for ketones if your levels are unusually and persistently high, despite corrections. If, for some reason the insulin is not getting through or not working properly your levels won't go down - I can testify to that 😱
Hi Liz,
I am surprised that you have never tested for ketones.😱If you have ketones and your levels are high then you are at risk of DKA - it makes sense to test because if the ketones are too high then your body cant naturally get rid of them without lots of insulin and water and sometimes that just isnt enough to do yourself at home - you might need help to flush them out at hospital. All newly diagnosed children are given the Optium xceed (well nearly all) and told to test for ketones if levels are unusually high. Also, you can get ketones if your levels are low - so testing is needed occasionally or if feeling ill generally. Ask your team if they can give you one.🙂Bev
Well... I've never had any problems, in 40 years, so is it really necessary? My OH and children (and the dog) tell me if they smell them, and I would inject another 20% correction insulin over 16, in fact my pump does that automatically. Can it do harm without you knowing? I drink about 5 litres a day anyway.
Oh, Bpd to have this question on your thread!
Oh, Bpd to have this question on your thread!
novorapidboi26
Well-Known Member
- Relationship to Diabetes
- Type 1
Ketones are acidic, so getting them processed quick is essential........
If I have ketones I need to know what level they are at so I know how much insulin to take, also a test every 2 hours until they are gone is usually the process I follow..........
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
It's worth having the ketostix (urine) sticks at least Rob, although the blood ketone strips give a more up to the minute reading.
novorapidboi26
Well-Known Member
- Relationship to Diabetes
- Type 1
I never really tested for ketones until I did dafne, and then the man flu came, the ketones stix came in very handy during that time
grandma
Well-Known Member
- Relationship to Diabetes
- Type 1
I was the same had the D for 36 years and never tested for ketones untill I did Dafne untill yhen never even been told to do it😱
Hi Liz,
I think the difference now is that we have the tools to be able to check and react quickly. If you are happy with the way you do things then there is no need to change - as long as what you are doing isnt causing any damage without you knowing.🙂Bev
Robster65
Senior Member
- Relationship to Diabetes
- Type 1
- Relationship to Diabetes
- Type 1
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Liz
Like you I've rarely had ketostix in the house. Even when I've thought of getting them I've usually forgotten to ask the GP to add them to repeat script
I've got some now (they came in the box of goodies with the Expert meter). only tested 'trace' once over the last few months (after several days of higher than normal levels).
I suspect some people produce ketones more readily than others (as always Your Diabetes May Vary).
It's a long tiome ago for us now... but can you remember how grim you felt at the time you were diagnosed? Raging thirst, lethargy, banging headache, vomiting maybe?
That was the ketones - DKA.
Like you I've rarely had ketostix in the house. Even when I've thought of getting them I've usually forgotten to ask the GP to add them to repeat script
I've got some now (they came in the box of goodies with the Expert meter). only tested 'trace' once over the last few months (after several days of higher than normal levels).
I suspect some people produce ketones more readily than others (as always Your Diabetes May Vary).
It's a long tiome ago for us now... but can you remember how grim you felt at the time you were diagnosed? Raging thirst, lethargy, banging headache, vomiting maybe?
That was the ketones - DKA.
Thanks Rob. So, if you have ketones present to a certain degree you should go to hospital? Do they take you seriously? I've had blood glucose in the 20s and definite ketones, but just give myself insulin, don't eat and drink a lot. would they really take you seriously? And do you refer yourself? And how? Surely you'd be more likely to contract something else going into hospital?
I've never felt sick or vomited and never in my life had a headache. i felt tired when diagnosed, and thirsty. And done for about 6 months. Couldn't walk easily.
I've never felt sick or vomited and never in my life had a headache. i felt tired when diagnosed, and thirsty. And done for about 6 months. Couldn't walk easily.
Robster65
Senior Member
- Relationship to Diabetes
- Type 1
I can only think of a couple of occasions when I've felt really dizzy and nauseous after being in the high 20s.
I've only had one box of ketone strips for the optium and never found more than a trace. As mike says, maybe some people are more susceptible than others but if they're there in any quantities, I would imagine they need to be flushed out or they will do damage.
Rob
I've only had one box of ketone strips for the optium and never found more than a trace. As mike says, maybe some people are more susceptible than others but if they're there in any quantities, I would imagine they need to be flushed out or they will do damage.
Rob
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
I had DKA when diagnosed. Of course, I didn't have any access to insulin, and that's why my levels of both BG and ketones continued to rise. I was almost comatose, hadn't eaten or drunk anything for 4 days, had lost 17 pounds in that time, had a suspected heart attack in hospital and was at risk of major organ failure. Basically, the ketones turn your blood acidic.
The thing is, that even if you have access to insulin, if you are fighting an infection (usually the cause of high levels + ketones present), then you may not be able to correct it yourself and then you need intraveneous insulin. You may have been lucky that you have never reached this stage, but it's always a danger.
Interestingly, a sizeable percentage of the population are unable to smell ketones, so it's not a reliable indicator.
Being on a pump it's really important to be able to test in some way. if the pump stops delivering insulin during the night then there may be quite a few hours with no insulin at all.
In children and young people ketones level rise far more quickly than adults.(that's true even in non diabetic children when starving)
Also,some people,have a bit more residual insulin than others and this acts as a brake on fat breakdown and ketone production unless glucose reaches very high levels or or stay raised for a long time.
Liz there is some good info here on what to do; Its very much the same as what Iwas told when I went on the pump...( though I was also given specific amounts of insulin to give a various ketone levels)
http://www.diabetes-education.net/pdf/resources/insulin_pump_workbook.pdf
P27 what should I do if I have a positive ketone test?
p29 a flow chart
Being on a pump it's really important to be able to test in some way. if the pump stops delivering insulin during the night then there may be quite a few hours with no insulin at all.
In children and young people ketones level rise far more quickly than adults.(that's true even in non diabetic children when starving)
Also,some people,have a bit more residual insulin than others and this acts as a brake on fat breakdown and ketone production unless glucose reaches very high levels or or stay raised for a long time.
Liz there is some good info here on what to do; Its very much the same as what Iwas told when I went on the pump...( though I was also given specific amounts of insulin to give a various ketone levels)
http://www.diabetes-education.net/pdf/resources/insulin_pump_workbook.pdf
P27 what should I do if I have a positive ketone test?
p29 a flow chart
randomange
Well-Known Member
- Relationship to Diabetes
- Type 1
I was concerned about not being taken seriously, or having to wait forever to be seen, so I asked about this at DAFNE. We were told to go to A&E, explain that you are a type 1 diabetic with high BG and ketones, and that you have been following your sick day rules as given to you by the hospital but you're having problems getting rid of the ketones. They said there might be several reasons why you might have to do this, e.g. being ill and struggling to keep anything (even water) down, and that they would rather we went to the hospital if we were unsure rather than struggle on at home - particularly as DKA can develop very quickly (I went from being relatively ok with a mild stomach bug to full blown DKA in less than 24 hours).
I think it's all a case of being prepared, and being comfortable that you can deal with it. I also think that what several others have said is correct, in that some people are more prone to ketones/DKA than others, and you might be one of those people who is less susceptible.
Hi Liz,
The 'sick day' rules say that if you have ketones of 1.5 or over then you should contact your healthcare provider and if they are over 3 then you need to go to A&E as this is considered to be dangerous and you could be heading for DKA. If you have never tested , then it could be that you often have ketones but that you are so used to it that you dont notice any symptoms or very little symptoms. It is not good to have acid raging round your body - you dont know what long term damage this can do and as you clearly do lots of research and are very wary of putting anything into your body that might cause harm (and rightly so) - then it surprises me that you feel that is is allright to have ketones and not worry about them. I think the difference between newly diagnosed type 1's now and those diagnosed years ago is that things have moved on and we know more now, so we are given the tools to be able to react to things like ketones simply because it is recognised that they are dangerous and can be fatal if not treated properly. Perhaps you could ask your team what their views are on ketones and how they would advise treating them. The Optium Xceed meters are often given free to clinics so perhaps they will be able to provide you with one.🙂Bev
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