I’ve had that undefined, non-covid respiratory virus that is like the worst cold ever with ear pressure, sore throat, and you are exhausted. I first felt bad about 10 days ago.
So on Friday, I called for a video visit and the doc prescribed augmentin & cough meds. On Sunday my bgl got very high (daughters confirmation and getting ready was stressful, a bite of cake at reception) & I had moderate ketones. I got it back under control. The bgl landed at 120 w/ trace ketones.
Monday and today bgl is running higher than it should and ketones are fluctuating between small and moderate. I called the advice nurse. She said they usually don’t advise er unless ketones are high, but she didn’t know about ongoing issues. She couldn’t get me in to see my endo for a couple of days online or in person. She left a message for them to call to advise me. But they never did.
Ketones for several days, bgl from 170-220 when it isn’t specifically corrected. Feeling breathy and back, muscles hurt. Drinking tons of water. When should I just go to urgent care/ER?
Are you eating low carb, or reduced your carbs due to feeling sick? This can contribute to low level of ketones.
Or could be bad insulin, so could try a new vial/pen. Or if on pump, a bad infusion set or dislodged set.
But if all that is ok, there may be internal infection or other problem causing stress and insulin resistance, resulting in high bg and ketones. Then trip to dr or urgent care could do tests to confirm.
Ketones are a sign you are burning fat. Therefore either you are not eating enough, or you are not eating enough carb. Or you are not taking enough insulin.
Those three are the only reason.
I am eating less and doing intermittent fasting. My ketones go from moderate to trace. I’m not worried because I am still taking my basal insulin even when I am fasting. That prevents acidosis.
@Timothy You can still go into DKA when taking insulin. Not enough insulin or the ability to utilize insulin to manage high blood sugar can cause the process to happen. Once the process starts it becomes harder to control.
We all know how fast our blood sugar can go up with a pump failure, and if your insulin is bad it can happen too. But also some illnesses can start the process as it can block your ability to utilize insulin properly.
Just being sick can be one of the triggers. While Covid has been known to set it off, who knows what other viruses could cause an issue. There is a particularly nasty respiratory virus going around right now. She has said she has been sick with a respiratory virus.
The back pain could be kidney pain. Drink lots of hydrating fluids and keep on top of your BG. You can go into DKA even in the low 200’s if not getting enough insulin. If you suddenly start throwing up get to the hospital as even if it’s not DKA related that can tip you into DKA. Fluids, fluids, fluids and if you can eat you should to bring down the ketones.
I don’t think you are currently in danger but better safe than sorry.
I recently went to ER for reaction to a pain Med I took for dental infection. I was on antibiotics and waiting for a root canal. My BG had fluctuated, but wasn’t high. When I went to ER my average BG according to my CGM was 150. Anyway, they said I had ketones! Early DKA! The ER doctor said glad you caught it early and that you can get DKA without high numbers! Idk, They gave me fluids and I left in a couple of hours. I followed up with my Endo. I met with my pump trainer the following week and she was satisfied with my uploaded CGM info.
Since then, I randomly check for ketones, no matter how I feel. I’m type I and take only novolog.
Many years ago, I had full blown DKA after getting food poisoning, I didn’t realize what it was at first, though I was talking to my primary office by phone everyday. I was very sick. (No pump or CGM then) Extreme nausea, stomach pain, limb pain, headache, etc. When I said I had labored breathing, they said GO TO ER NOW! I did and it was intense. ICU and 5 day hospital stay, but full recovery.
When I have concerning highs now, I change my entire set of infusion and reservoir several times, moving to various sites. I recently switched to a new vial of insulin, though it had recently been opened.
I also consider if I have a UTI or other illness that’s driving it up.
Hopefully, your doctor can give you specific instructions. I know it can be very stressful.
Hi, i really hope you are feeling better now. These are the “rules” i was taught a few years ago here in the UK. Have helped me out numerous times. HG.01-003-v3-Sick-day-rules-Pump.pdf (210.0 KB)
