Will ketone stay high if the blood glucose is normal?

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s14ali

s14ali

Active Member
Relationship to Diabetes
Type 1
Hello,

Firstly, I briefly saw some posts about Ketone but cannot find the answers what I need to know.

My blood sugar was staying high between 9mmol/L and 11-12mmol/L for almost one week. I've increased the insulin dosage but it didn't work then it went back to normal in three days ago but I still have to monitor it.

I was thinking why it was high then realised that I might have ketone as I saw some website. Today, I used ketone test strip (Ketostix) and it revealed 1.5mmol/L in the morning and three hours later - 4mmol/L(near match the colour). Oddly, the blood sugar was 6.8mmol/L but I will do more tests, it could be misread. However, it seems accurate result and sounds serious?

I had a ketone test strip before in probably 2014/2015 and it was fine, I had type 2 at that time. I have type 1 and it's the first time that ketone revealed a minor positive. Maybe I didn't have enough a combination of insulin and carbs.

I have an appointment on next week to discuss it with nurse.

In case, I understand about ketone but I have a few questions:
  • Does it increase the blood glucose? I think it does.
  • Does it make you feel tired and difficult to breathe if the blood glucose is normal?
  • I have B12 tablets, does it affects on ketone?
 
s14ali said:
Hello,

Firstly, I briefly saw some posts about Ketone but cannot find the answers what I need to know.

My blood sugar was staying high between 9mmol/L and 11-12mmol/L for almost one week. I've increased the insulin dosage but it didn't work then it went back to normal in three days ago but I still have to monitor it.

I was thinking why it was high then realised that I might have ketone as I saw some website. Today, I used ketone test strip (Ketostix) and it revealed 1.5mmol/L in the morning and three hours later - 4mmol/L(near match the colour). Oddly, the blood sugar was 6.8mmol/L but I will do more tests, it could be misread. However, it seems accurate result and sounds serious?

I had a ketone test strip before in probably 2014/2015 and it was fine, I had type 2 at that time. I have type 1 and it's the first time that ketone revealed a minor positive. Maybe I didn't have enough a combination of insulin and carbs.

I have an appointment on next week to discuss it with nurse.

In case, I understand about ketone but I have a few questions:
  • Does it increase the blood glucose? I think it does.
  • Does it make you feel tired and difficult to breathe if the blood glucose is normal?
  • I have B12 tablets, does it affects on ketone?
Click to expand...
You might find this a useful explanation of ketones and it might explain your situation.

Ketones and diabetes

High levels of ketones in your blood or urine can mean you're at risk of developing diabetic ketoacidosis. This can be life-threatening, so it's important to be aware of your ketone level. On this page, we'll explain what ketones are and go through how to spot the symptoms. We'll also show you...
www.diabetes.org.uk www.diabetes.org.uk
 
Had you eaten enough carbs when you checked ketones?
 
How long has your pot of Ketostix been open? Once the seal is broken I think they are only good for a few weeks/months before they start to degrade. Also, if it is a new pot of Ketostix and you just broke the seal for these tests, did you follow the directions to dip the strip for just 15 seconds?
In reality you don't generally need to test for Ketones unless your BG levels are persistently mid teens or above. ie not just a food spike but a premeal level.

It is actually the high BG levels and insufficient insulin which causes ketones to develop and become toxic rather than ketones causing high BG levels. Ketones can develop due to long periods of fasting or a low carb diet, but these ketones are not toxic and pose no problem unless your BG levels are high which makes your blood acidic. I would not expect these type of ketones to go much above 1 though.
 
rebrascora said:
How long has your pot of Ketostix been open? Once the seal is broken I think they are only good for a few weeks/months before they start to degrade. Also, if it is a new pot of Ketostix and you just broke the seal for these tests, did you follow the directions to dip the strip for just 15 seconds?
In reality you don't generally need to test for Ketones unless your BG levels are persistently mid teens or above. ie not just a food spike but a premeal level.

It is actually the high BG levels and insufficient insulin which causes ketones to develop and become toxic rather than ketones causing high BG levels. Ketones can develop due to long periods of fasting or a low carb diet, but these ketones are not toxic and pose no problem unless your BG levels are high which makes your blood acidic. I would not expect these type of ketones to go much above 1 though.
Click to expand...
I opened it yesterday, it's new. Yeah, I read the instructions about the timing when checking the result.

I've tested before meal. I do know that I need to test ketone test strip if the blood glucose is too high. However, Ketone can be slightly high even the blood glucose isn't high, according to website. That's why I use it because I don't know why I always feel tired when the blood glucose is normal in between 6mmol/L and 7mmol/L. I've already mentioned about the tiredness in my previous posts and I was asked to check the varied tests - VB12, thyroid, etc. It is quite confused.

Yesterday, I was very tired all day. :(
 
s14ali said:
I always have low carb foods and calculate the number of insulin units to match it but I think I should have more carbs.
Click to expand...
Eating low carb foods will cause ketones
 
How long have you been eating low carb and how many carbs do you eat a day? Can you give us an idea of the sort of things you typically eat for breakfast/lunch/evening meal and any snacks so we can understand your situation a little better?
Could the fatigue possibly keto flu if you haven't been doing a keto diet very long?
Could it be a food allergy? @Lucyr has been suffering badly for months with fatigue and headaches and has just started going Gluten Free and is finding the fatigue is significantly reduced even in a relatively short space of time, so that might be worth trying.
 
rebrascora said:
How long have you been eating low carb and how many carbs do you eat a day? Can you give us an idea of the sort of things you typically eat for breakfast/lunch/evening meal and any snacks so we can understand your situation a little better?
Could the fatigue possibly keto flu if you haven't been doing a keto diet very long?
Could it be a food allergy? @Lucyr has been suffering badly for months with fatigue and headaches and has just started going Gluten Free and is finding the fatigue is significantly reduced even in a relatively short space of time, so that might be worth trying.
Click to expand...
I always choose 15-20grams of food carbs, three/four times a day. Overall, I would say about 50grams of carb per day, I know this is very low. I am struggling with the blood level in each hours. o_O

In morning, I eat mixed nuts with protein powder. I used to eat the medium food carbs such as oats but it seems not working as it quickly increase the blood glucose even the insulin dosage is matched. My body/blood circulation is probably highly sensitive. So, I have to increase the dosage but seems useless as it likes I am having insulin as foods. :(

In lunchtime and evening. I mostly eat vegetables that are below medium starch in food groups. And I eat a small amount of meat protein because if I had a large amount of meat, it can increase the blood glucose after 1/2 hours and stay high for aleast three hours.

I never done Keto diet before.

The foods that I eat, it doesn't have gluten and I wonder why I feel fatigued. Even if I had a food with gluten, it would be the same result.
 
Do you eat plenty of fat? That diet sounds quite low in calories.
Porridge is like rocket fuel for me too and not worth the effort of trying to balance out the spike with insulin but even with a low carb breakfast like berries and seeds with creamy Greek yoghurt, I need to prebolus 45 mins to prevent a spike in levels. The fat from the cream in my coffee and the creamy yoghurt provides me with slow release energy.

The protein release 2 hours after meals needs extra insulin but it's not a big deal unless you find extra injections a difficulty, but you shouldn't limit your protein because of that. We need insulin and our body would release it like that to manage the protein if our beta cells hadn't been destroyed, so don't feel that it is wrong to inject insulin for protein, or to eat more carbs and inject more insulin. You need to feed your body and give it the insulin it needs to utilize that food and it sounds to me like you might be starving your body a bit and hence the ketones are starvation ketones. I may be wrong on that but from the information you have given, that sounds likely to me.
 
rebrascora said:
Do you eat plenty of fat? That diet sounds quite low in calories.
Porridge is like rocket fuel for me too and not worth the effort of trying to balance out the spike with insulin but even with a low carb breakfast like berries and seeds with creamy Greek yoghurt, I need to prebolus 45 mins to prevent a spike in levels. The fat from the cream in my coffee and the creamy yoghurt provides me with slow release energy.

The protein release 2 hours after meals needs extra insulin but it's not a big deal unless you find extra injections a difficulty, but you shouldn't limit your protein because of that. We need insulin and our body would release it like that to manage the protein if our beta cells hadn't been destroyed, so don't feel that it is wrong to inject insulin for protein, or to eat more carbs and inject more insulin. You need to feed your body and give it the insulin it needs to utilize that food and it sounds to me like you might be starving your body a bit and hence the ketones are starvation ketones. I may be wrong on that but from the information you have given, that sounds likely to me.
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I always add any kind of unsaturated fats and fibre. Which insulin injection are you using (prebolus 45mins) and which body part to inject? I assume your insulin is different to mine.

Yeah, you're right about the body starvation and my foods is always low. It is very unusual for me that protein can increase the blood glucose as I've tried to experiment it. As we know that protein don't have carbs but it acts like carbs. According to medical website, some people have a body sensitivity in blood control and insulin resistances.
 
I use Fiasp now.... I used to have to wait 75 mins prebolus before breakfast with Novo(not so)Rapid 🙄 Most other times of day I just need 5-20 mins with Fiasp but at breakfast time I have a strong "Foot on the Floor" liver dump which my insulin has to overcome before it is free to work on my breakfast. I also seem to have very fast digestion.

I inject bolus in my abdomen. Basal goes into buttocks, with the dose split evenly between each and if I need an evening dose of Levemir it is usually just a couple of units and goes into a thigh. No issues with absorption so far, but Fiasp is such a "coward" when faced with bigger BG levels and if my levels get above 10 it just seems to turn to water and run away. I usually have to stack corrections once I get above 10 so I proactively inject corrections at 8 or 9 to keep below 10 and this seems to work really well for me. I never test for ketones so I have no idea what a normal level would be for me with normal BG on my lowish carb way of eating and I don't let my levels get high enough to warrant testing ketones.
 
s14ali said:
I always add any kind of unsaturated fats and fibre. Which insulin injection are you using (prebolus 45mins) and which body part to inject? I assume your insulin is different to mine.

Yeah, you're right about the body starvation and my foods is always low. It is very unusual for me that protein can increase the blood glucose as I've tried to experiment it. As we know that protein don't have carbs but it acts like carbs. According to medical website, some people have a body sensitivity in blood control and insulin resistances.
Click to expand...

Sometimes it’s actually harder to get a good blood glucose level if you eat too few carbs. This happens to me when I eat just protein and vegetables. If you ate more carbs through the day, including to accompany protein, you might find things easier. I get better blood glucose levels adding carbs to stop the protein rise. I need a minimum of 25-30g carbs to stop the protein rise. You’ll find a good carb level for you.
 
I find the injections in the abdomen work quickest, thighs and upper lets are medium. Bum is suposed to be slowest so i keep that for basal.
What you may find useful is experimenting with prebolusing....on the same meal. For example, i hsve breakfast nutty museli. I need at least a 25 min prebolus at breakast time. Other meals i normally need 15min prebolus, though less for a particularly fatty meal and more if its a lost of qickly digesting carbs (whicj i generally avoid cos then i will spike)
I also have different ratios on non work days (1 to 20) and work days (1 to 8). I also walk for 20 min after most meals. I have a small number of low carb midday meals which i know will not spike me even without a walk, for working days
At first, standardise as much as you can and see what the best prebolus (walk lenth/insulin/carb ratio,) is for you by experimenting. Once you have that down pat you can branch out.

Personally I found low carb useful at first so your spikes aren't massive when you do get it wrong. I agree best not go too low carb otherwise you have to also count protein and fat, and ain't nobody got time for that!
 
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