Raised ketones with normal blood glucose

[John D M]

Hi,
Hoping for a bit of advice or perspective.

I’ve been taking Forxiga / Dapagliflozin for 10 weeks and have found BG control much easier and insulin requirement dramatically less.

Less positively, I have slightly raised ketones -1.1- but with fairly normal glucose -7.7. Yesterday I had a COVID vaccination and have felt more unwell as the day passes today and expect that this I connected. Unfortunately I felt on waking and took my Dapagliflozin as normal.

Any advice or sharing of similar experiences would be very helpful.
Should I be unconcerned by the modestly high ketones?
I‘m drinking, eating carbs and taking a little more insulin - anything else that might be helpful?

Thanks
John

 

[Inka]

There is something called euglycaemic ketoacidosis @John D M which is associated with certain meds (and other things). It’s ketoacidosis with normal blood sugar. Read more here:

Euglycemic diabetic ketoacidosis caused by dapagliflozin: A case report

Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked hyperglycemia, ...

www.ncbi.nlm.nih.gov

I’d keep a close eye on your ketones, keep hydrated, eat and take your insulin and, if in any doubt, seek medical input.

The ketone guidance is here:

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

.

 

[John D M]

There is something called euglycaemic ketoacidosis @John D M which is associated with certain meds (and other things). It’s ketoacidosis with normal blood sugar. Read more here:

Euglycemic diabetic ketoacidosis caused by dapagliflozin: A case report

Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked hyperglycemia, ...

www.ncbi.nlm.nih.gov

I’d keep a close eye on your ketones, keep hydrated, eat and take your insulin and, if in any doubt, seek medical input.

The ketone guidance is here:

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

.

Thankyou

 

[Wendal]

Hi John.As Inka says it is DKA with normal blood glucose levels. But you should treat it in exactly the same way as a normal DKA.

 

[John D M]

There is something called euglycaemic ketoacidosis @John D M which is associated with certain meds (and other things). It’s ketoacidosis with normal blood sugar. Read more here:

Euglycemic diabetic ketoacidosis caused by dapagliflozin: A case report

Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked hyperglycemia, ...

www.ncbi.nlm.nih.gov

I’d keep a close eye on your ketones, keep hydrated, eat and take your insulin and, if in any doubt, seek medical input.

The ketone guidance is here:

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

.

Thankyou

 

[John D M]

Hi John.As Inka says it is DKA with normal blood glucose levels. But you should treat it in exactly the same way as a normal DKA.

Thankyou