FU - Low level Ketones


Okay so this follows from another discussion about me not feeling well and feeling nasues and losing weight and thinking it was an allergic reaction to Levemir. I have been looking online and checking my ketones and i have had ketones of 1.5 the last couple of days. I down 4 glasses of water and they go away but how concerned should I be ? When i wake up in the morning they are back to.

I changed to levemir and my sugars were quite high but have come down now, but have has an awful taste in my mouth, thirsty, weak hands, naseus for the last 4 days and low level ketones.

The reading online is scary - when should I be worried ? when does ketoacidosis set in ?

I think you need to worry now. Ketoacidosis can catch a person very quick and this sounds like how I used to be just before a hospital visit. Go and get checked out at your doc just to be on the safe side.

My dr is closed must i go to the hospital ? I just checked and there arent any anymore but still sweet taste sore tummy feel anxious

If you have been feeling like this for a while, then I suggest you go and get checked out. They will at least be able to put your mind at ease. Don't panic but don't ignore it either.

What is your blood sugar ? How high is it ?

You need to interpret ketones "in context." If you have not been feeling well, not eating, but have a reasonable blood sugar (70-140 mg/dl) then ketones will simply reflect a natural process where your body burns body fat since you don't have enough dietary carbs to fuel yourself.

On the other hand, if you are feel unwell and have a high blood sugar (> 200 mg/dl), then ketones are a red flag and you should consider it a warning sign of potential DKA.

The key is your blood sugar. How is your blood sugar?

ps. The treatment for DKA onset is to aggressively bolus corrections to restore normal blood sugars and drink electrolytes to help your body flush out toxins and extra blood sugar. The safe things is always to check with your doctor.

pps. Everyone fasts overnight and generates ketones (except those that sleepwalk and go eat). Trace or marginal ketones in the morning are often a normal reflection of fasting and burning fat overnight.

Right now its 11.8 was 21 earlier had a stressful job interview over lunch that took ages . Checked ketones again and nothing - do i really need to go to the hospital. Stressing me about big time now . Dr closed so hospital or nothing . Surely i need ketones in my urine now to be worried ? or would low levels over a couple of days be enough to bring it on ?

I have been looking at your page Char and it seems you've been feeling unwell for a while. If your bg are this unstable I really think you should go to the hospital, just to be on the safe side. The very least they can do is give you proper sachets to restore your electrolytes. I see you live in Dublin, you may have a long wait at the hospital, so if possible bring someone and some water, glucose, insulin etc.

How did you feel before you had to go to hospital ? My boyfriend thinks im crazy cause there arent any ketones when i check - wont they think the same at the hospital ? Maybe its just anxiety ?

I felt weak, tired, sick and very agitated. I only went to hospital when I got really ill, when I started to vomit. If I had gone earlier I would have recovered a lot quicker and do less damage to myself. It's not as though you are some eejit drunk off the street, this is a geniune medical case and the doctors will tell you that it's better to get it checked out.

even if i dont have ketones now ?

what were your ketones before you went to the hospital ?

Yes, they need to know how you have been feeling these last few weeks and how your bloods are running. My ketones were 5 when I got to the hospital.

11.8 to 21 corresponds to 212 to 378 mg/dl. This is a high blood sugar. When you have ketones and a high blood sugar, it is a red flag. Josephine has given you sound safe advice. If you checked your urine for ketones and you found none, you have avoid an immediate crisis, but you absolutely must be diligent about this.

There very well could be something wrong with you, you could be sick somehow, perhaps an infection. You may think you can deal with it only to find that is not the case. But you are an adult, you need to make a choice. In either case, it is important to correct high blood sugars. Round the clock. Test every 3-4 hours and correct as needed. Once you normalize your blood sugars it still may take a day or two before you actually feel better. But if you can return your blood sugars to normal range and restore insulin levels you can prevent the onset of DKA. But keep in mind, if you have not felt well for weeks, something could be wrong.

So i went to the hospital and they ran tests and checked everything and appparntely i was fine. So I went home had something to eat , waited and just before bed tested for ketones and they were 1.5 , did another test this morning and they are 4 ???!!! This is crazy must I go back,

Also thanks everyone for your help !! Felt much better and slept well after getting it checked out, duno why they are back again though !! Time to get drinking !!

I agree with everyone else tht you should get it fixed. My solution for elevated BG is "take more insulin" or make adjustments so more is being taken, sometimes both.

Ketones can stack. If you do not allow your kidneys to remove them they can buildup. So going in and out of ketosis can cause you to go into ketosis faster each time. It is a dangerous game to play.

The only way to remedy this is to get your sugars to normal for a few days.
If you can't, you can switch to lantus for a while. If you are on lantus, you will not go into DKA even if your sugars are high, as long as you take it every day.

In any case you can not walk around with sugars like that. You need an overhaul by your Endocrinologist.

WHo could even tell what is happening. If you being sick is throwing your sugars off, or if your crazy sugars are making you sick.

Just one addition: the Levemir insulin is described as an 24 hour insulin. This is true BUT the activity of the insulin is NOT distributed equally over 24 hours. The problem is that the duration and shape also depends on the dosage. To really get equal distribution you need to split the dosage. If your Lantus dosage was 24 then inject 12 units of Levemir in the morning and 12 at night (12 hours apart). Both shots will overlap and this will make sure that you always have an sufficient level of basal on board.

i am on split levemir. My sugars are better today and my ketones seem clear. I did go to the hospital hoping they would do something but they just did tests and told me to go home. I am currently taking 8 units levemir twice daily and this seems to be okay today. Bought super wholegrain bread so gona make sure i have two slices at every meal. I basically cut out carbs after reading dr rubensteins book and think this contributed and yes think the ketones stacked and have prob been there a while. Will keep testing and if I have some later will go back to the hospital but tested 3 times today and sugars at 7mml.

Why wouldnt you go into DKA on Lantus ?