I have reduced my carb intake from approximately 250g/day to 101 g/day. I notice; however, that my urine ketones often get to a moderate level by the afternoon. When this happens I find I must increase my basal rate. My question does the ketone production cause insulin resistance? This has been particularly troubling if I have had nighttime hypoglycemia the in the early morning.
Are your moderate ketones accompanied by high BG? Could you be dehydrated? Have you tried drinking water & testing for ketones again?
I eat low carb, 30-35 grams, daily for over 4 years. 101 grams shouldn't result in ketosis, so am curious what your BG readings are & why you're testing for ketones.
Other things can cause moderate ketones--some drugs can give false readings, metabolic disorders, illness.
You are likely cutting back on your carbs too radically. Slowly reduce your carb levels down to 100g/day to allow your body to adjust (over weeks). Your body is burning body fat to make up for the rapid carb reduction. This creates Ketones.
It depends on what is meant by high sugar. These ketones begin to appear at bg's in the 150 to 200 range at which time I begin correcting. The sugars will slowly decline and then begin to increase again. Yesterday I had lower ketones with higher bg after increasing the basal rate. Some of this may be Somogyi effect due to preceding hypo, but this lasts over 12 hrs. I test for ketones because ketones can tell me if a pump site is failing, and I am curious about what is happening metabolically.
My hope is that I am indeed burning fat, but the reduction has not been all that rapid. I have been lowering carbs since May. While my BMI is just under 25; my fat composition at 34% makes me obese. I lowered my carbs so I could use less insulin, but if sugars rise as a result of the ketones, then I will take more insulin than the carbs should demand. I am back to gaining weight instead of losing!
BG isn't rising as a result of ketones. It's high BG causing moderate ketones. At 101 gr carbs, you shouldn't have ketosis. Ketosis, of course, results in weight loss. Yep, you need more insulin to prevent highs. It's still less insulin than you'd be using for higher carb. Insulin needs change frequently.
If you're eating more protein than previously, about 58% of protein converts to glucose & at a slower rate than carbs. Adequate protein is essential, but excess protein stalls weight loss & can cause weight gain.
I believe a lot of the sugar problem is the increased conversion of protein to glucose. However, one of the difficulties with excessive ketones from inadequate insulin is it takes more insulin to get the same fall in bg. My question is does the same thing happen at lower bg levels. I think when I got a moderate ketone at about 160 mg/dl. Of course, the ketones could be left over from the hypoglycemia, but the test was not run on the first part of the void. In fact, my total insulin for those two days was about the same as when I was eating more than twice the carbs.
First thing to look into is if you're eating more protein than you need. You can lower carbs further. Never heard of ketones from hypogylcemia. I've noticed a difference in correction ratios with really high BG. It's not the same as correcting a moderate high.
Insulin doses change & frequently. We need what we need. No point in allowing BG to be high. Take care of that & you won't have ketones. Problem solved. Also, make sure you're hydrated. Everyone has slight ketones in the morning simply from fasting.
Hypoglycemia might produce ketones for reasons similar to starvation.
You're right. Since we're told to check ketones with high BG, I wasn't thinking lows could do the same.