on those crappy days when you have BG rises for no reason, when do you check for ketones? I’ve noticed that if I’m anywhere over 200 I show anywhere from trace to large ketones. I can also be at 400 and have no ketones. I know that the ketostix aren’t necessarily accurate and I know that
high BGs don’t necessarily go hand in hand. my endo says to not bother testing for ketones unless I’m in the high 300s but the nurse says i should call her whenever I have the large ketones but I’m not supposed to be testing for them at numbers under 300? I don’t know, I’m helpless and scared and alone today. any relating or advice is welcome
I normally check my ketones anytime it's 250 or higher just to be safe! Sometimes even when my numbers are high, I get a reading showing no ketones. When my blood sugars get over 200 I normally do a correction and automatically start drinking water to get my sugars down. The water also helps flush out the ketones in my body.
Yeah I'm sure.. Ketones are always scary! I know I went to a local doctor one day because I was sick as a dog and I was dehydrated and blood sugars was sky rocketing because of my sickness, no matter what I did it just wouldn't come down. The doctor told me that I needed to be admitted to the hospital because of my ketones where they could keep a 24 hour check on me. She refused to give me any medication for my cold even after I refused to go to the hospital cause I knew that I could get rid of my Ketones alone without medical help. So I suffered for a while longer, while my body healed.
well, i heard that ketones are not everyhing. you can also get ketones from 1 day fasting. i was told to only check ketones if i am high and wanna do sports, cause it can get pretty dangerous there. other than that i go by the rule: if you feel bad, take care and rely on your body consciousness...
thanks to both of you. the idea of calling the doc every time I have ketones seems crazy. I’m very diligent and take car to get rid of them but don’t want to be in a state of panic about them
I don't fully understand the reasoning behind checking ketones. if your blood sugar is high, you probably have ketones so what do they tell you that your meter doesn't? None of my drs ever said anything about checking ketones(even when my bg was sky high at diagnosis), so I wouldn't even know how to check them if I wanted to. If someone could enlighten me as to what I am missing I would appreciate it. :-)
Well, with Ketones you are supposed to notice if you go into DKA. So if you are going into one, it might show as ketones in your urine. There are strips you can pee on, and they get different colours for different amounts of ketones. because there are different kinds of high blood sugars, at least with me.
there is one i get when i have no or not enough insulin at all, eg when my cannula kinks. those are the "bad" ones, cause you have no insulin at all in your body and therefore your body starts burning fat and ketones result. from these high bgs a DKA is most likely to happen and i feel the worst while having these (tg they happen very rarely).
then tere is a high bg that happens for example when i forget to bolus, lets say for pizza. these many carbs boast my bg up, but i still have my basal insulin which gives my body sugar to burn, so it can function. there the ketone production is not that high and i normally dont feel that bad, the DKA risk isnt very high there either.
That is what i know about ketones, high bgs and why some doctors recommend testing for ketones, to catch a DKA early. maybe i could help a bit.
everyone have a great day,
love, swisschocolate
A high BG with ketones is more serious than a high BG without ketones, particularly if you use an insulin pump. A high BG doesn't automatically equal ketones. Ketones only develop with high BG when the level of insulin in your system is so low that there's not enough to meet even your baseline needs. You can have enough insulin to meet your baseline needs but not enough to control your blood sugar, in which case you'll have high BG but not ketones. This can happen if you don't take enough insulin for food you eat, for example. If you don't have enough insulin to meet your body's baseline needs, you'll have high BG and high ketones and be at increased risk for DKA. This can happen if you're sick and your insulin needs suddenly change drastically, or if you're on a pump and have interrupted insulin delivery for some reason.
I agree with swisschocolate, a high BG with high ketones feels MUCH worse than plain old high BG with no ketones.
my thing has been blood sugars that aren’t sky high with large ketones, which is frustrating. one night my basal is just right and then next night it rises overnight and I get ketones. this crap is for the birds
most people wake up with ketones from just fasting. how high is high in terms of your blood sugars, are you on MDI or pump? If you're having high ketones in the middle of the day with high blood sugars, this is not good. Do you low carb? I feel very ill when I have high BG's and ketones (not enough insulin, as Jen said and explained it very well)...you'd be feeling pretty ill if you're continually having high ketones from not enough basal insulin.
I havent checked for ketones for ages. The times I did check after my dka I never had any ketones. I rarely go above 200 now but I was in dka at 279 at my diagnosis and it progressed rapidly to severe dka. At that time I already had high ketones. Ketones can mean dka so yes you need to be careful. I could be wrong but if you're not having the other dka symptoms at a high of 200 and above I would just correct and drink water, exercise if that lowers you and wait till you come down. I'm on mdi so I think the chances of me going into dka are very low unless I miss a basal dose and keep forgetting it- which won't happen or if I'm sick and become insulin deficient/resistant- I don't do strenuous exercise.
Checking for ketones should be done when you have the conditions of risk for DKA. Elevated blood sugar and in particular a blood sugar that is not responding to a bolus. At what elevated blood sugar you should become concerned is is something everyone needs to make a decision about on their own, but probably > 300 mg/dl is a good start. My strategy (which I have actually never had to use) is to test for ketones when my blood sugar doesn't respond to bolus. When having a blood sugar over my correction threshold, I immediately bolus with an IntraMuscular (IM) injection. I just do it in my quad some people use their deltoids. I can then walk around to make it work even faster, but the bolus should have an observable effect within about 15 minutes. If that failed to nudge my blood sugar down below say 300 mg/dl, I would then start checking for ketones and be alert to DKA problems. It is my belief that if you can bring your blood sugar down on your own, even if you read high ketones, you are unlikely to need a trip to the ER.
ps. Simply getting to the ER probably takes a half hour and then if you are really unlucky, you may wait there for a couple hours before anyone sees you.
I'm on a pump. my insulin needs change a LOT. I'm caught between two basals right now, .4 makes my BG drop overnight and .45 causes my BG to rise. The other night I went to sleep at 220 and after about 5 hours to 295. I had large ketones. I was clearly getting some insulin, but not enough. I did a correction and did NOT call the doc because I corrected? My BG finally drifted down to 235 and the ketones disappeared. That was a great night's sleep! I don't know, I'm very "brittle" and like I said, my insulin needs change, so my numbers aren't great. But the ketones only make an appearance at night. I'm working with my CDE to get my numbers down, adjusting nighttime basals. every time we come up with something everything changes
