Ketones: when to worry?

So this morning my set change kinked and threw me into the high 200’s. I changed the site again and took some insulin. I’ve never had a problem with ketones, in the last 6 years, I’ve only had one positive test and it fell into “trace” amount. I use ketostix. Anyway, I’m feeling super nauseated and tested for ketones. It tells me I’m “moderate” at 40mg/dl. I’ve never had this many.
I’ve been sipping water, but I’m not sure how much longer I’ll be able to keep it down. All I can think about right now is throwing up. My last test didn’t show much improvement in BG (at 290) so I just took another shot.
My question is; when is it time to worry? Is a “moderate” ketone reading something I should be handling on my own? when is it time to call on help?
I’ve been fighting to keep my water down for fear of becoming dehydrated, but I really, really just want to go ralph.
Does anyone have any suggestions or words of encouragement? Thanks in advance, I’m really glad I have all of you to rely on for help.

If you are showing moderate it is time to call your doc’s office and see what they suggest.

Everyone is different, I can run 290 for days without issue. Moderate, time to make a call. THey may just suggest increasing basal rate or something.

Haha thanks for pointing that out, Dave. I edited my post. I’m usually able to spell it correctly but not feeling that great at the moment. My brain is mushy.

And I don’t usually have a problem with the Quick Sets. This is my first kink in years. I will ask for a sample of the Sure-T’s though. I like the thought of just moving it instead of having to use a whole new set.

Amanda, How long has it been since you took a correction bolus? If it has not lowered any in the next hour or so you may want to take a correction bolus with a syringe. Test frequently, at least once every 30-40 minutes. If you are still at the same levels, use a syringe or pen; Injected fast-acting insulin will probably work quicker for you., If you continue to spill moderate to large ketones after an injection, it may be time to call your doctor to see what his/.her directives are.
Dave, this young woman is sick, she doesn’t need you to rip on her spelling. I make abundant typos as well. Ease off the sarcasm some, my friend., I know you mean well in your Quest to fill the Minimed pumping world with Sure-T users, but there is a time and place for sarcasm…Using it when speaking to a person who is sick will IS NOT the time and place. You know me well enough ,by now, from the other site and this one , to appreciate my candor and convictions.Take care and be kind.

God Bless,

I have been high(er) for longer periods of time in the past without showing any ketones at all. This is new to me. Even when I was dx’d, I was in the 700’s. They kept me for 3 days, brought me down really slowly and I never showed any.
I will probably call, although after my second correction the nausea seems to be fading pretty rapidly. Now i’m just tired & getting a headache.

I have had moderate and high ketones and dealt with them at home (no doctor visit). Ketones will not disappear immediately. Check again in 4-5 hours.

When I had similar events, then it took more insulin than usual to correct the high.

So drink as much water as you can handle and check for ketones and your blood sugar.

Let us know how you are doing!!

Hi Amanda when I get high and feel like i’m gonna hurl I drink ice cold peppermint tea, it really helps.Just drink real slow and small sips. I 've had problems with kinks (one really scary time)too. I almost never use ketone strips but I do have them just in case.

Glad that you are starting to feel better!

When I know why I have ketones (bad infusion set), then I am less worried than if ketones would show up and you had no idea why.

You don’t have to be too high to have ketones, the sudden lack of insulin caused by a bum infusion set is enough to make them show up pretty quickly.

I had problems with kinks with the 9mm quickset, but the 6mm ones work great for me!

Thanks Kristin, I appreciate your advice. I would really prefer to handle it on my own. I don’t like to involve extra people unless necessary and I dislike my drs. The nausea is gone, but I feel like I’m gearing up for a pretty decent headache. I’m feeling much more confident in being able to handle this on my own. I was mostly worried about being able to keep the fluids down and I’m doing that without a problem now. It’s definitely taking more insulin than usual to get below 200 though. Kinda touch and go.

I use the 6mm and still have trouble finding sites sometimes. I don’t have very much fatty tissue. I really like using my back, though. I get really consistent results and never have site problems. I had tried to move it to my stomach this morning when it kinked.

Yeah, the process your body is going through is exhausting. So take it easy if possible. Lots of water and some rest and you should be back to your good ol’ self soon!

Have you tried upper, outer thighs? I use my 6mm quicksets there and like it a lot. I usually put an IV300 tape over it to lower the chances of ripping the site out when I pull my pants down.

So my last correction bolus was an hour ago. It’s been pretty difficult to get under 200, but my BG is now 195. I have been testing BG and Ketones every half hour. My previous Ketone test read “trace”. I thought it might be a mistake because I was still in the 200’s. But I just checked again and got a “negative”.
Is it normal to have ketones out of your system that quickly? it has only been about 1 1/2 hours since I last had “moderate” readings. I thought it would take longer. And my sugars are still pretty elevated even though they’re on the decline.
I will still continue to check just to make sure nothing has changed, I am feeling much better than I had earlier, just very tired now. Even the headache is subsiding a bit.

Thank you SO MUCH to everyone who replied, you all really helped to calm my nerves.

Great news! I think it is normal to have them pass that quickly. The longest mine lasted was 4 hours.

Take it easy!

ok so you two fighting isnt helping Amanda at all.
Dave, chill out some, because Brunetta means well.

The Original Poster,Amanda, fortunately, did not find the “Joke” offensive, and is now feeling better. I guess we do not all have the same sense of humor: Though I have experienced it Very few tines in my 41 years as a type 1,I still do not find probable/potential DKA in the slightest bit funny,not for myself nor for anyone else. But as I said, we are all different.

God Bless

As irony would have it, I just changed my infusion set during this discussion and my blood sugar has been hanging around 200, despite a correction bolus.

I have (only) trace ketones, but the little strip did turn a little pink.

Just gave an injection and will decide soon whether to rip the Quickset out of my upper thigh.

Ah, diabetes.

Wow, that is ironic. I’ve been feeling much better, subsequent tests are all negative and BG was just at 76. I’m glad I handled everything myself. I was very nervous to see that strip turn maroon this morning. I didn’t have any clue how long it would take to flush them out.
I used to use my upper thighs alot but all of a sudden stopped getting very good absorption. That’s what prompted me to try my back. Now that is my favorite spot.

Glad you made it through , Amanda.

God Bless,

Thanks guys. I felt better just to be able to talk about it earlier. It feels good to know there are other people who have been through this before, no matter how rough it may get sometimes. It also feels good to know I can bounce back pretty quickly too.
Now I’m hungry!