So something strange happened to me yesterday. The day started out normal, I woke up with a BG of 157, I gave a bolus to bring me down to a good number. I took my morning pills (Metformin, birth control, low dose aspirin, metoprolol…and a new drug I just started called Cymbalta) with a glass of water. I ate eggs and sausage for breakfast, a larger breakfast than I normally eat, but not huge. I did a mid-morning workout -a short ten minute ride on my bike. Lunch was very small because I wasn’t hungry and had zero appetite, but my BG felt as if it was dropping (even though the meter said 97 and holding steady) so I forced myself to drink a cup of coffee with a bit of vanilla cream and a slice of pepper jack cheese. I felt much better immediately after I ate.
Later in the day, around 4ish, I began to feel nausea but I ignored it. My BG was at 116 at this time. Around 5:30 I ate a decent meal comprised of low carbs, lots of veggies and some meat and cheese. This made the nausea go away and all was good for several hours.
I noted that I was eating more protein today than I usually do.
I checked my BG a couple of times throughout the evening, it held steady at around 118 until I ate a Snow Ball (a cake type treat), I bolused for it of course but my BG still spiked as high as 213 so I corrected.
Around 9:30 I began to feel nausea again. By 11:00 my BG was still high at 197. I corrected again but took into consideration that I still had insulin on board so I took less.
Around 11:30 I checked for ketones because the symptoms I was feeling reminded me more of DKA than a stomach bug or flu. The test indicated I had moderate ketones (over 40 mg/dl).
After the puking I felt much better. I drank a large glass of water and then went to bed. My BG at this time had dropped down to 159.
I don’t understand why I would get sick with ketones when my BG’s have been very good this past week (primarily in the 80-140 zone).
Things I’ve changed this week are that I’m doing much more exercise, to the point were my muscles have been sore, I take a higher dose of Metformin (2K mg, up from 1500 mg), and I started Cymbalta. I had to stop taking Farxiga (last pill was on Friday morning). I did slack on my water intake yesterday. And I just got a flu vaccine and tetanus shot on Friday morning.
The only times I’ve ever experienced DKA was when my BG was massively high over an extended time and I had a virus. I know it’s possible to have moderate to high ketones with normal BG, but I’d like to figure out how this happened so I can prevent it from happening again.