Testing for ketones?

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Caroline1967

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Relationship to Diabetes
Type 2
I am frequently getting levels above 18. Have spoken to my nurse who says although dka not likely in type two it is possible so I should test when levels are high. He has given me 10 testing strips. In the last two weeks I have tested 3 times and all is fine. I have woken this morning at 19.4. I feel thirsty and a bit tired but otherwise fine. I feel testing would a waste of a strip! Do I need to test if I feel ok?

I am speaking to the nurse next week, if I can get an appointment as I am worried that my levels are still that high. I doubled my gliclazide to 160mg daily but it doesn’t seem to have made much difference!

Thank you for any advice anyone can give.
 
I’d test @Caroline1967 You’re not wasting a strip if you’re checking for ketones. You could also buy some Ketostix (urine test strips) for around £5 for future use.

I remember your problems from before. I don’t understand why you’re not receiving more support (and meds) to get your blood sugar down.
 
Off topic a bit, but did you ever have the tests to check you’re not Type 1?
 
Thanks. I am getting fed up with such high levels and no proper support too. It has been 16 months now and I don’t feel any more sorted than when I was first diagnosed. I have asked several times about type one and been told no need to test as it won’t be that! I am 50 and overweight so it must be type 2! It is all very frustrating!
 
Whatever type you are, you need more help to get your blood sugar down @Caroline1967 Perhaps you need some insulin? How many carbs a day are you eating? Is your blood sugar pretty much always high or does it come down a bit sometimes? What did you have for your evening meal last night and what was your blood sugar before eating?
 
Hi Inka
Thanks for taking the time to reply. I am getting really fed up with all of this now!!! I am trying to stick to about 130 grams of carbs a day but will admit to having a little more some days. Last night I had a small jacket potato so about 45g carbs and some chicken and veg...nothing too outrageous. I was 12 when I had dinner and 14 when I went to bed. Woke up at 3am and was 19. When I got up at 6.15 I was 18.4. I have been using a libre for the last month and I frequently go up to 20+ at 3 am. I have spoken to the nurse about this and he has doubled my gliclazide to 160mg a day. I have tried to get an appointment with
 
posted too soon!

tried to get an appointment with him but I have to ring every morning and I haven't managed to get one yet. I think I may need to take more medication but I am a bit nervous about doing it without talking to the nurse. I have another 3 libre left so can keep track of what is happening if I do change the meds. (I got given the libre because a friend has had a pancreas transplant and is not longer diabetic and she had 4 left over so added to the two I bought to go on holiday (which both failed within the first hour of wearing them!!! - replaced by Abbott) IU have 3 months seeing what is happening all of the time.
I did test for ketones this morning and it was only 0.4 so nothing to worry about.
 
Caroline1967 said:
Last night I had a small jacket potato so about 45g carbs and some chicken and veg...nothing too outrageous. I was 12 when I had dinner and 14 when I went to bed. Woke up at 3am and was 19. When I got up at 6.15 I was 18.4.
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Gosh @Caroline1967 - tnat does seem a sustained and dramatic reaction to a fairly modestly carby meal (and a fairly low-carb menu generally].

Have you even been checked for insulin production (via cPeptide), or possibly GAD antibodies (though the chances of false negative for that increase with duration of diabetes).

The meds you are currently on don’t seem able to help you manage your glucose levels :(
 
Caroline1967 said:
Hi Inka
Thanks for taking the time to reply. I am getting really fed up with all of this now!!! I am trying to stick to about 130 grams of carbs a day but will admit to having a little more some days. Last night I had a small jacket potato so about 45g carbs and some chicken and veg...nothing too outrageous. I was 12 when I had dinner and 14 when I went to bed. Woke up at 3am and was 19. When I got up at 6.15 I was 18.4. I have been using a libre for the last month and I frequently go up to 20+ at 3 am. I have spoken to the nurse about this and he has doubled my gliclazide to 160mg a day. I have tried to get an appointment with
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If I were you, I think I’d try lowering my carbs in tiny steps (tiny steps because you’re on Gliclazide and don’t want to risk a hypo, unlikely as you might think that is). 130g is the max for low carb. I’d try to eat fewer carbs and see if that helps. You’d have to do this gradually and carefully, but it’s worth a try, especially as you say you have some weight to lose.
 
Yeah I think I am going to have to cut out more carbs. I am going to persevere with trying to get an appointment with the nurse and will ask again about a GAD test but I don't hold out too much hope as I asked before and was just told 'no' with no explanation really about why not! I am sure I will get there in the end, but it is a rather long journey!! Thank you for suggesting things to help.
 
Caroline1967 said:
Hi Inka
Thanks for taking the time to reply. I am getting really fed up with all of this now!!! I am trying to stick to about 130 grams of carbs a day but will admit to having a little more some days. Last night I had a small jacket potato so about 45g carbs and some chicken and veg...nothing too outrageous. I was 12 when I had dinner and 14 when I went to bed. Woke up at 3am and was 19. When I got up at 6.15 I was 18.4. I have been using a libre for the last month and I frequently go up to 20+ at 3 am. I have spoken to the nurse about this and he has doubled my gliclazide to 160mg a day. I have tried to get an appointment with
Click to expand...
I’d say that rise sounds about right, I’ve always been told to assume 10g carbs without insulin raises bg by 3mmol. You had 45g carbs without bolus insulin and only went up by 7, so half what I’d go up by for that.
 
Given the limitations of CGMs and how they are designed to be most accurate at "normal" levels (between about 4 and 8mmoo/l), I am less convinced by their value when levels are consistently above 10. In my experience, they wildly over estimate highs. For example, yesterday mine reported 15 when the finger prick was 11. I would definitely not trust a Libre reading over 20 which checking with a finger prick.
Using Libre may make you think you are more in control but it may be adding to the stress.

It is very concerning to see such high numbers for so long and know It may be causing damage. Being over 50 certainly does not exclude Type 1. Recent study showed that 40% of people with Type 1 are diagnosed over 30 and it has been known for new diagnosis in the 90s.
And having Type 1 does not stop us getting overweight.
 
@helli - I agree with that last sentence. I know darn fine well that's true! I'm nowhere near as active as I used to be and even then when on DSF a good many years ago now we did a straw poll about how many grams of carb we all consumed most days, I discovered I only usually ate about 80g - as well as walking and housework, gardening, decorating etc with NP - and had thus stayed pretty slim for the previous 40-ish years.

I changed jobs in the 1990s and a senior chap there told me he'd had a conversation with an ex colleague of mine, saying he'd been told that I was now going to work there and lots of people seemed to already know me, but he didn't - so, what was I like, in his opinion? And my 'mate' Andy had replied 'Blimey - fancy you not knowing her! I thought nearly everybody in Birmingham in insurance knew her - a jolly, little, fat person who is known for doing things properly'. Well thanks for the 'fat' sweetheart ....... though must admit, true at the time!
 
everydayupsanddowns said:
Gosh @Caroline1967 - tnat does seem a sustained and dramatic reaction to a fairly modestly carby meal (and a fairly low-carb menu generally].

Have you even been checked for insulin production (via cPeptide), or possibly GAD antibodies (though the chances of false negative for that increase with duration of diabetes).

The meds you are currently on don’t seem able to help you manage your glucose levels :(
Click to expand...
I am attempting to get an appointment to discuss the meds but I have to ring at 8 am and at that time I am busy at work so it is hard to find the time and when I rang at 10.30 there were none left. Going to try again on Monday. Also going to reduce carbohydrates and see if I can change things that way too.
 
helli said:
Given the limitations of CGMs and how they are designed to be most accurate at "normal" levels (between about 4 and 8mmoo/l), I am less convinced by their value when levels are consistently above 10. In my experience, they wildly over estimate highs. For example, yesterday mine reported 15 when the finger prick was 11. I would definitely not trust a Libre reading over 20 which checking with a finger prick.
Using Libre may make you think you are more in control but it may be adding to the stress.

It is very concerning to see such high numbers for so long and know It may be causing damage. Being over 50 certainly does not exclude Type 1. Recent study showed that 40% of people with Type 1 are diagnosed over 30 and it has been known for new diagnosis in the 90s.
And having Type 1 does not stop us getting overweight.
Click to expand...
Thanks for replying.
I am checking with a finger prick when it is very high and libre is running about 1mmol higher so not drastically different.
Am cutting down on carbs now and will make a nurse appointment as soon as I can.
 
Caroline1967 said:
I am attempting to get an appointment to discuss the meds but I have to ring at 8 am and at that time I am busy at work so it is hard to find the time and when I rang at 10.30 there were none left. Going to try again on Monday. Also going to reduce carbohydrates and see if I can change things that way too.
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Does your GP do eConsult? At mine you can fill the form in at any point when the surgery is open. It it triaged and then goes to the appropriate person. I know it's a pain but could help you get to speak to someone.
 
I agree that "eConsult" or "AskMyGP" or whatever other online options might be available is the easiest option if your surgery operate one of those systems. I was diagnosed through that system 4.5 years ago. I sat at home on a Sunday evening and filled in the proforma screen with my symptoms etc. Got an email Monday morning from the GP saying an appointment had been made with the nurse for a blood test the next day (Tuesday) and got my diagnosis on Wednesday! Very quick and efficient and no hanging on the phone! Sadly not all GP practices have adopted this system, but worth checking to see if yours does use it.
 
Thanks. I will try econsult on Monday and see what happens.
I will get there in the end, I am sure!!
 
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