Q re ketones

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Cate

Cate

Well-Known Member
Relationship to Diabetes
Type 1
I'm almost embarrassed to be asking this, since I've been type 1 for 26 years, but anyway...

Ketones: I know nothing about them, other than they lead to DKA (which I don't really understand either to be honest). I have never tested for them that I know of, I don't know when I should test for them and what to do about it if I had any. I've got some ketostix knocking around somewhere I think, but have had them for years so they're probably out of date.

Can someone put me out of my misery? I see them mentioned a LOT on here, and someone said they're more common if you use a pump, which I've done for the last 6 years.

If I had a high BG reading I'd be giving a correction dose and retesting every 30 mins or so to monitor things until it came down to approaching a normal level, should I be doing something different if I had ketones?

Thank you! 😱
 
Ketones are a nasty thing that appear if you don't have any insulin knocking about in your body, or none at all, and so the body can't make use of the glucose in a good way - in essence ketones turn the blood to acid and pretty much act like a poison.

With a pump, risk of DKA is greater if the pump fails or you become disconnected or whatever as you won't get any insulin inside you. And as you know, without insulin our poor withered pancreas body's can't handle it so ketones make their way in quickly.

If you have high readings then the best thing to do is keep on top of it, take a correction dose and drink plenty of water to flush any ketones out. It's recommended to test for ketones if a) levels are high (I usually go for anything above 16) and b) you're unwell. Keep testing every half an hour or so and make sure they're coming down. And I would say keep testing ketones until they've gone.

I use the optium xceed for ketones testing, brilliant little machine and much much better than those pee sticks
 
Thanks! How did you get the xceed? From your clinic or buy it? Will have to investigate that one I think.
 
Hi Cate, ketones are formed when the body doesn't have enough insulin available to process the glucose in the blood for energy, so it turns to burning fat. A by product of this process are ketones, which unfortunately also need insulin to help the body process them. If there is insufficient insulin circulating then the ketones can build up in the blood and traise its acidity. This can lead to severe problems, including organ failure and coma, but usually DKA before that. The body tries to get rid of the ketones in the urine and even through the lungs, so peeing on a ketostix will show their presence, and they can also be smelled on the breath (a pear drops smell). A lot of Type 1s have ketones when diagnosed because their pancreas has stopped working. Once you are taking your injections it is far less likely, unless you are ill and need a lot more insulin than you normally would.

Pumpers are more prone because if the pump stops working for whatever reason, there is no basal insulin to help, so they rise much quicker than someone who has injected basal. If you are monitoring your blood and keeping it under control with corrections, you may be OK, but you should also be checking that the ketones are not increasing in spite of this.

Ketostix expire 6 months after opening. Blood ketone sticks are better, but expensive and only come with one meter, the Optium Xceed.

Hope this helps!

edit: I see Sam got there before me...
 
Cate said:
Thanks! How did you get the xceed? From your clinic or buy it? Will have to investigate that one I think.
Click to expand...

Ring up Abbott Diabetes Care and ask for one 🙂 you'll get one for free if you tell them you'll use it to test your BGs (its what I said LOL, I don't use it for that at all!)

http://www.abbottdiabetescare.co.uk/inspired-products/optium-xceed

here's the contact us page

http://www.abbottdiabetescare.co.uk/contact-us

they won't send you ketone strips though, believe me I tried...you'll have to get them on prescription from your GP. I had a fight and a half on my hands though! You may be able to buy them, but I gather they are mega expensive but as a T1 you should be able to get them on script.
 
I got a free one from my DSN (I dont use it though, my GP says the strips are too expensive....but hey, thats a whole other subject!).

Just thought Id add that in, just incase you can get your mitts on a free-be!
 
thanks guys. interesting about the ketones, thinking back i was never even tested for them in hospital last december when i was given steroid injections while pregnant to mature the babies lungs, i ran my basal at 400% its normal rate for about 4 days as a result. all that happened was i had to call my dsn to discussmy bloods every day.

so what level do ketones start at roughly? does it vary? what affects it? my control has been so tight during pregnancy that i get hyper symptoms for readings in double figures, but hypo awareness is shocking and doesn't kick in till i'm below 3 normally.

and sorry for poor typing/formatting, am feeding the baby!
 
It's really only a problem if your levels are high (17+) and still rising, despite corrections, which means that your body is having a tough time coping even with the insulin you are giving it - like when you are ill (and often before other symptoms of illness appear). It can happen too if you try exercising when your levels are high, as again you don't have enough circulating insulin to process the glucose. Others might be able to give you personal experiences, I have only had them to my knowledge when I was diagnosed - my blood was practically like that monster's in Alien! 😱
 
Good question Cate as i like you have been diabetic far too long now and i too know very
little about ketones etc.

All a bit of a worry as i have never been advised about such things in all my days...

Congrats with the baby by the way...you are a whizz at multi tasking 🙂

Bernie xx
 
Since I'm peppering the forum with my poems tonight, how about this one, The Ketone Cops:

Send officers quickly, there?s been a calamity!
I?m beginning to think that I?m losing my sanity!
I?ve lost so much weight that I?m light as a feather,
And I?m sweating profusely, though it?s hardly hot weather!

I keep throwing up, with an insatiable thirst ?
Do you know what it is? You can tell me the worst!
I haven?t stopped p?ing from dawn until dusk,
And soon I?ll be looking like an old dried out husk!

My breath smells of pear drops ? that acetone smell,
Oh please come and help me, you can tell I?m not well!
I?m panting and wheezing and my heart?s fit to burst,
I feel helpless and dizzy and wretched and cursed!

Don?t worry, stay with us, for help?s on its way!
We?re thinking that maybe you have DKA?
We?ll get you some insulin and you?ll be right as rain,
And tell you how to make sure it won?t happen again.

If your blood sugar?s high and your insulin?s low,
It?s likely that ketones will soon start to show.
You need to be vigilant ? keep them on the hop,
And we?ll make you an honorary Ketone Cop!

:D
 
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