O.5 keytone reading

[rayray119]

Well there currently at 0.9 so waiting for a call from a 111 nurse it might be due to my mess uup this morning

 

[rayray119]

I haven't learnt to do corrections yet. So can't deal with it that way and and it's nigjt time

 

[Inka]

Hope you’re ok @rayray119 It could be your ‘mess up’ but it could be something else. Don’t blame yourself.

Let us know how you are in the morning. Look after yourself.

Edited to add - what was your blood sugar when you tested for the ketones? Corrections aren’t really something you need to learn. It simply means having a little extra fast-acting insulin to bring your blood sugar down when necessary. Your team should be able to give you a correction factor - that is, how many mmols 1 unit of insulin will drop you. In your case, you’ll probably need very little insulin to drop you a fair few mmols.

I’ve got a cold and I tested for ketones for the first time in more than a year. It’s not something you should be doing regularly and the usual trigger for testing is high blood sugar. Ask your team to give you a number - a blood sugar above which you should be testing. That number might be 13, 14, 15. Ketones are for a reason (usually high blood sugar). They don’t pop up for no reason and they’re generally not something that we need to think about all the time.

I’d also ask for support with your anxiety. DSNs know how stressful diabetes can be at first and are very sympathetic and helpful. You could also speak to your GP to get some help. I really think that that will help you manage your Type 1 better and reduce your stress.

 

[rayray119]

Ended up going to a and e because 111 referred me saw the dirlbetic nurse. They said I did everything right with regards for checking for keytones told me how to corrections(the diabetic team at the hospital) there were 1.2 about a hour so I'll check on them again in an hour well 3 o'clock if they rise above they get 1.5 sort out the insulin they told me to do.

 

[Inka]

I’m glad you got good support @rayray119 and that you’re ok 🙂 Knowing how to do corrections will be a great tool for you.

 

[rayray119]

Yes it will rather then just leaving it alone not knowing. It's still all had to deal with I'm not even sure uve probably comes to terms with it

 

[rayray119]

Down to O.5 now however I blood sugers were 15.7 so I did a correction for that after being explained how to do that today (2 units of norvo rapid) they told me to s correction for anything above 12

 

[rayray119]

Just for reference the advice from the paediatric team is to check ketones if your BG is over 16 (at the time you would usually do a finger prick). Any ketones under 1 are basically fine and will be rectified through usual dosing. Ketones 1-2.9 require one level of correction (10% of body weight) and ketones of 3.0+ double that. So for someone is 70kg who has ketones of 2.3 it would be 7 units by pen (not pump), for ketones of 3.3 it would be 14 units (don’t add a BG correction). (I don’t know if the 10% remains over 100kg, my chart only goes up to 100). Keep checking BG and have sugary drinks if you go below 5 having given a ketone correction. If you are unwell you may get significant ketones with a BG under 16 so it can be worth checking ketones if you’re unwell (covid has had some people showing ketones with a BG of only 10) but generally you would only check ketones if BG is over 16 and even then you might not check if you know why they’re high and just correct as normal. We very rarely have any need to check for ketones. It’s not something you need to be doing on a regular basis. We had an overnight pump problem last week where my 11yo had a BG of 22 when they woke up (no dexcom on that day) and felt sick. They had ketones of 1.5 so we did the appropriate correction for that and it was fine afterwards. They’ve had BG of 22 before without ketones so I suspect it was a combination of no food overnight with the high BG that caused the ketones.

How long does it take for a correction to work after you give it either glucose or keytones

 

[rebrascora]

I would hope to see a reduction in BG levels within 2 hours of a correction but insulin can sometimes be slow to kick in especially when levels are high because you become more insulin resistant.
You should not give another correction within 4 hours minimum to allow that insulin to work. Injecting sooner is called "insulin stacking" and can be dangerous because you end up with 2 doses of insulin active at the same time and it can have a cumulative effect or interfere with the bolus calculation of your next meal, so please be patient if your levels aren't showing any sign of coming down just yet.
If you are able, going for walk will help the insulin to be more effective and/or drinking plenty of water. Do make sure to take your testing kit and hypo treatment with you if you go for a walk.... or walk up and down stairs 20 times or put some music on and have a dance.... or use an exercise bike if you have one.... just steady.... nothing too exertive.

 

[rayray119]

Im about to eat though surely I should have my uaeal meal time dose?

 

[rayray119]

But they have come down. To 8 so hoping I didn't read the thing wrong

 

[Kaylz]

Yes you should still take the dose for your food

What do you mean read the thing wrong?

The trouble is they have probably used the 1 unit brings you down 3mmol as that's standard for how they start you, just not everybody is the same and 1 unit could bring you down more than 3mmol or less xx

 

[Inka]

How long does it take for a correction to work after you give it either glucose or keytones

I find it depends on my blood sugar level. If I’m at the lower end of high, if that makes sense, it will work in 2hrs or even a little less, but if I’m over 13 or 14, I can sometimes see no down movement for my blood sugar until around 3hrs. I’ve learnt to wait in those circumstances as I’m expecting it to take a while to get moving. Once it does get going, it then drops reasonably quickly.

Did your team give you any suggestions as to the cause of your high sugar?

 

[rayray119]

Yes you should still take the dose for your food

What do you mean read the thing wrong?

The trouble is they have probably used the 1 unit brings you down 3mmol as that's standard for how they start you, just not everybody is the same and 1 unit could bring you down more than 3mmol or less xx

Sorry I meant I hope I didn't get a glade reading of 15 the first time I did wash my hands and double check though. Although 8.0 is still high and I just for the first time tried crab courting for the first time they did say I could but when I was in the hospital they said to have then with swanich I eat because I had been high. However I'll get there with

 

[rayray119]

Hope you’re ok @rayray119 It could be your ‘mess up’ but it could be something else. Don’t blame yourself.

Let us know how you are in the morning. Look after yourself.

Edited to add - what was your blood sugar when you tested for the ketones? Corrections aren’t really something you need to learn. It simply means having a little extra fast-acting insulin to bring your blood sugar down when necessary. Your team should be able to give you a correction factor - that is, how many mmols 1 unit of insulin will drop you. In your case, you’ll probably need very little insulin to drop you a fair few mmols.

I’ve got a cold and I tested for ketones for the first time in more than a year. It’s not something you should be doing regularly and the usual trigger for testing is high blood sugar. Ask your team to give you a number - a blood sugar above which you should be testing. That number might be 13, 14, 15. Ketones are for a reason (usually high blood sugar). They don’t pop up for no reason and they’re generally not something that we need to think about all the time.

I’d also ask for support with your anxiety. DSNs know how stressful diabetes can be at first and are very sympathetic and helpful. You could also speak to your GP to get some help. I really think that that will help you manage your Type 1 better and reduce your stress.

Oh forgot to reply to this i tested becauuse they said to test if I missed a dose and I may have done. I just had a similar issue but this time I was just a small drop on the skin rather than loads in not going to panic though and just keep an eye on things in not going to panic though and just keep an eye on things if any issues arise I know how to deal with them now

 

[Inka]

@rayray119 I presume by “testing” they simply mean a blood glucose test. Yes, if you’re worried you forgot an insulin dose or that the full dose didn’t go in somehow, you should test your blood sugar.

But testing for ketones is something that should only be done very occasionally - ie if your blood sugar is high or if you’re ill. You shouldn’t be testing ketones all the time. It’s an occasional test for specific circumstances.

If you keep your blood sugar within a reasonable range, ketones won’t suddenly sneak up on you when all’s well. That’s not how they work. Now you can correct highs and that’s good news.

 

[rayray119]

@rayray119 I presume by “testing” they simply mean a blood glucose test. Yes, if you’re worried you forgot an insulin dose or that the full dose didn’t go in somehow, you should test your blood sugar.

But testing for ketones is something that should only be done very occasionally - ie if your blood sugar is high or if you’re ill. You shouldn’t be testing ketones all the time. It’s an occasional test for specific circumstances.

If you keep your blood sugar within a reasonable range, ketones won’t suddenly sneak up on you when all’s well. That’s not how they work. Now you can correct highs and that’s good news.

no in the hostpal i was diganosed they spefictlly said to test for keytones if I was ill like had a virus or if I missed a dose and they did crop up at night when that happeded

 

[Inka]

no in the hostpal i was diganosed they spefictlly said to test for keytones if I was ill like had a virus or if I missed a dose and they did crop up at night when that happeded

Yes, but I still think your anxiety is making you worry too much about ketones when there’s usually no need 🙂 The first step is always to test your blood sugar. If you think your injection ‘leaked’ a little, then test your blood sugar and if you’re under whatever number your team suggested (usually 13-16) then you don’t need to test for ketones.

You seem to be treating ketone testing like glucose testing, but glucose testing is a very frequent thing and ketone testing is a very occasional thing. I say that not to criticise but to clarify. I understand anxiety in general (had it myself and it’s crippling) and I understand why you’ve fixated on the ketones a bit, but Type 1 is a burden enough day by day without adding extra worries that aren’t needed.

The feature of diabetes is very raised blood sugar. Ketones are a side effect. We should always be aware of the possibility of getting them at a level that matters, but that’s to be aware not because it’s likely we’ll have them often and have to deal with them. I’ve had Type 1 almost 30 years and I can count the number of times I’ve had ketones high enough to raise concern on the fingers of one hand. I’m not special. That’s normal. I tested recently when I had a cold because I was ill and was worried about Covid, but prior to that the last time I tested was sometime last year, I think.

Now you’re able to do corrections, you’ll find it easier to control your blood sugar. Learning to live with Type 1 practically is a gradual thing. You’ll gradually get the tools and the knowledge to control it, and you’ll gradually gain the experience you need. But what people often totally underestimate is the mental and emotional burden of it. Dealing with that takes ‘tools’ too. How you think about Type 1, how you fit it into your life, how you deal with worries connected to it, and how you learn to live along side it, keeping it in its cage, always being aware of it, but not letting it take over your life. Life is so much more than Type 1. Once you get into your stride, you’ll be able to push Type 1 back a little in your head. X

 

[rayray119]

Yes, but I still think your anxiety is making you worry too much about ketones when there’s usually no need 🙂 The first step is always to test your blood sugar. If you think your injection ‘leaked’ a little, then test your blood sugar and if you’re under whatever number your team suggested (usually 13-16) then you don’t need to test for ketones.

You seem to be treating ketone testing like glucose testing, but glucose testing is a very frequent thing and ketone testing is a very occasional thing. I say that not to criticise but to clarify. I understand anxiety in general (had it myself and it’s crippling) and I understand why you’ve fixated on the ketones a bit, but Type 1 is a burden enough day by day without adding extra worries that aren’t needed.

The feature of diabetes is very raised blood sugar. Ketones are a side effect. We should always be aware of the possibility of getting them at a level that matters, but that’s to be aware not because it’s likely we’ll have them often and have to deal with them. I’ve had Type 1 almost 30 years and I can count the number of times I’ve had ketones high enough to raise concern on the fingers of one hand. I’m not special. That’s normal. I tested recently when I had a cold because I was ill and was worried about Covid, but prior to that the last time I tested was sometime last year, I think.

Now you’re able to do corrections, you’ll find it easier to control your blood sugar. Learning to live with Type 1 practically is a gradual thing. You’ll gradually get the tools and the knowledge to control it, and you’ll gradually gain the experience you need. But what people often totally underestimate is the mental and emotional burden of it. Dealing with that takes ‘tools’ too. How you think about Type 1, how you fit it into your life, how you deal with worries connected to it, and how you learn to live along side it, keeping it in its cage, always being aware of it, but not letting it take over your life. Life is so much more than Type 1. Once you get into your stride, you’ll be able to push Type 1 back a little in your head. X

well in hotisal they said i did the right thing by keeping an eye on them

 

[Inka]

well in hotisal they said i did the right thing by keeping an eye on them

It’s always sensible to be aware of ketones, yes, but earlier you said:

“If I'm honest Im having a constant fear of keytones at the moment”

I think that’s a very astute observation. It’s a balance of legitimate awareness of the possibility of high levels of ketones and excessive anxiety and over-testing. I hope your team can help reassure you and that things settle for you as time goes by.