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High Ketones Normal Blood Sugar

Blood Glucose Levels Above 400

Blood Glucose Levels Above 400

In order to reduce the risk of long-term health problems, a goal of therapy in diabetes is to achieve near-normal blood glucose, or blood sugar levels. But even in the short-term, it’s important to prevent high blood sugars, since significant elevations may be associated with an array of symptoms including dehydration, increased risk of infections, and the life-threatening conditions diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). Since DKA and HHS are serious conditions that can lead to coma and death, blood sugar levels above 400 mg/dL should be considered a medical emergency. Video of the Day Diabetes mellitus is a condition that leads to high blood sugar levels. In diabetes, blood sugars tend to run well above the normal range -- which depending on the laboratory is somewhere between 70 to 100 mg/dL. If you have type 1 diabetes (T1DM), elevated blood sugars are caused by an absence of insulin, the hormone that is necessary to remove excess glucose from the blood. In type 2 diabetes (T2DM), blood sugars levels run high due to impaired insulin production or action. Factors that worsen blood sugars include illness, certain medications, inactivity, or diet -- such as eating large portions or excessive carbohydrates. Blood sugars can also increase if diabetes medications are not taken regularly. Measuring your blood sugar is an important way to manage diabetes, as glucose meter results can alert you to a problem well before symptoms occur. Classic symptoms of high blood sugars include thirst, frequent urination, dry skin, fatigue, drowsiness, blurred vision and sometimes unintentional weight loss. Infections -- such as skin or urinary tract infections -- are also more likely to occur when blood sugars are elevated. Symptoms may not be noticed unt Continue reading >>

Must Read Articles Related To High Blood Sugar (hyperglycemia)

Must Read Articles Related To High Blood Sugar (hyperglycemia)

A A A High Blood Sugar (Hyperglycemia) (cont.) If hyperglycemia persists for at least two or three days, or if ketones appear in the urine, call a doctor. Generally, people with diabetes should test their blood sugar levels at least four times a day: before meals and at bedtime (or following the schedule advised by the prescribed individual diabetes care plan). The urine should be checked for ketones any time the blood sugar level is over 250 mg/dL. When blood sugar stays high despite following a diabetic diet and plan of care, call the nurse, diabetes health educator, or physician for adjustments in the diet. If blood sugars are high because of illness, check for ketones and contact a health professional. Vomiting Confusion Sleepiness Shortness of breath Dehydration Blood sugar levels that stay above 160 mg/dL for longer than a week Glucose readings higher than 300 mg/dL The presence of ketones in the urine Ketoacidosis or diabetic coma is a medical emergency. Call 911 for emergency transport to a hospital or similar emergency center. Please ask your health care professional about the following: How to recognize high blood sugar levels How to treat a high blood sugar level when it occurs in you, a family member, or coworkers How to prevent the blood sugar level from becoming too high How to contact the medical staff during an emergency What emergency supplies to carry to treat high blood sugar Additional educational materials regarding high blood sugar Check blood sugar levels with a blood glucose meter. If blood sugar level is higher than normal, but there are no symptoms, continue routine care such as: Take all diabetes medications on schedule. Eat regular meals. Drink sugar-free and caffeine-free liquids. Take a blood sugar reading every four hours (write it down) u Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don't have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or keto acids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations. In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death. Ketoacidosis is always accompanied by dehydration, which is caused by high Continue reading >>

High Blood Sugar (hyperglycemia) In Diabetes

High Blood Sugar (hyperglycemia) In Diabetes

What is high blood sugar? High blood sugar means that the level of sugar in your blood is higher than recommended for you. If you don’t keep your blood sugar at a normal, healthy level most of the time, you will increase your risk of heart and blood vessel disease, stroke, kidney problems, and loss of vision. The medical term for high blood sugar is hyperglycemia. Blood sugar is also called blood glucose. What is the cause? Blood sugar that stays high is the main problem of diabetes. Your body breaks down some of the foods you eat into sugar. Normally the hormone insulin moves this sugar into your cells, where your body uses it for energy. In diabetes the insulin is not moving the sugar into the cells, so it builds up in the bloodstream and starts to cause problems. Sometimes you may have high blood sugar even though you are taking diabetes medicine. This can happen for many reasons but it always means that your diabetes is not in good control. Some reasons why your sugar might go too high are: Skipping your diabetes medicine Not taking the right amount of diabetes medicine Taking certain medicines that increase your blood sugar or make your blood sugar medicines work less well Taking in too many calories by eating large portions of food, choosing too many high-calorie foods, or drinking too many high-sugar beverages Eating too many carbohydrates, such as foods made mainly with sugar, white flour (in bread, biscuits, pancakes, for example), white potatoes, or white rice Not getting enough physical activity (exercise lowers your blood sugar) Having increased emotional or physical stress Being sick, including colds, flu, an infected tooth, or a urinary tract infection, especially if you have a fever If you are using insulin, having a problem with your insulin (for examp Continue reading >>

When To Worry About Ketones

When To Worry About Ketones

“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>

Everything You Need To Know About Ketones

Everything You Need To Know About Ketones

Ketone is an organic compound that the body produces when fats are broken down for energy. People with diabetes may not be able to regulate the level of ketones in their blood, so ketone testing is an essential part of managing their condition. There are three types of ketone, which are collectively known as ketone bodies, or ketones. In this article, we explain when to check for ketones, the types of tests available, and how to understand the results. Contents of this article: What are ketones? The body uses a range of nutrients for energy, including carbohydrates, fats, and proteins. It will use carbohydrates first, but if none are available, the body will burn fat for energy. When this happens, ketones are produced. Ketones have gained attention in recent years due to the popularity of ketogenic diets, in which people eat a low carbohydrate diet so that their body will burn fat instead of carbohydrates. There is currently a lack of clear evidence on the benefits of this diet, and there may be some risks, such as high acidity in the blood and loss of muscle. Typically, carbohydrates are broken down into different nutrients, including blood sugar (glucose), by an enzyme called amylase that occurs naturally in the body. Insulin then transports the sugar to cells to be used for energy. A person with diabetes does not produce enough insulin to transport the blood sugar, or the cells in their body may not accept it properly, which stops the body from using the blood sugar for energy. When sugar can't be used by the cells for energy, the body will start to break down fats for energy instead. Types of ketone and DKA Three types of ketones are always present in the blood: acetoacetate (AcAc) 3-β-hydroxybutyrate (3HB) acetone The levels of each of these ketone bodies will var Continue reading >>

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Diabetic Ketoacidosis GENERAL INFORMATION: What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your blood sugar levels become high because your body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces your body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in your blood. Ketones are dangerous at high levels. What increases my risk for DKA? Not enough insulin Poorly controlled diabetes Infection or other illness Heart attack, stroke, trauma, or surgery Certain medicines such as steroids or blood pressure medicines Illegal drugs such as cocaine Emotional stress Pregnancy What are the signs and symptoms of DKA? More thirst and more frequent urination than usual Abdominal pain, nausea, and vomiting Blurry vision Dry mouth, eyes, and skin, or your face is red and warm Fast, deep breathing, and a faster heartbeat than normal for you Weak, tired, and confused Fruity, sweet breath Mood changes and irritability How is DKA diagnosed? Your healthcare provider will ask about your symptoms and how you manage your diabetes. He will also look for signs of dehydration. Your blood and urine may be tested to check your blood sugar and ketone levels. These and other tests will show if you are dehydrated. You may also need an EKG to check your heart rhythm. You may need more tests to find out what triggered your DKA. How is DKA treated? DKA can be life-threatening. You must get immediate medical attention. The goal of treatment is to replace lost body fluids, and to bring your blood sugar level back to normal. You may need any of the following: IV liquids help t Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) occurs when the body does not have enough insulin. Insulin is what breaks down sugar into energy. When insulin is not present to break down sugars, our body begins to break down fat. Fat break down produces ketones which spill into the urine and cause glucose build up in the blood, thus acidifying the body. Because sugar is not entering into our body’s cells for energy breakdown, the sugar is being processed by the kidneys and excreted through the urine; as a result, we become dehydrated and our blood becomes even more acidic. This leads to sickness and hospitalization if not treated. If a person’s blood sugar is over 240, they should start checking their blood for ketones. If you have diabetes, or love someone who does, being aware of warning signs of diabetic ketoacidosis (DKA) can help save a life. Early Symptoms of DKA: High blood glucose level, usually > 300 High volume to ketones present in blood or urine Frequent urination or thirst that lasts for a day or more Dry skin and mouth Rapid shallow breathing Abdominal pain (especially in children) Muscle stiffness or aches Flushed face As DKA Worsens: Decreases alertness, confusion – brain is dehydrating Deep, labored, and gasping breathing Headache Breath that smells fruity or like fingernail polish remover Nausea and/or vomiting Abdomen may be tender and hurt if touched Decreased consciousness, coma, death If you think you might have DKA, test for ketones. If ketones are present, call your health care provider right away. To treat high blood sugar, hydrate with water or sugar free, caffeine free drinks. Sugar free popsicles and snacks are also good alternatives. Always call the doctor if vomiting goes on for more than two hours. Symptoms can go from mild Continue reading >>

Ketones: Clearing Up The Confusion

Ketones: Clearing Up The Confusion

Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>

Diabetes And Illness

Diabetes And Illness

It is very important to know how to cope with illness if you have diabetes or know or care for somebody with diabetes. If in doubt, always seek advice from your doctor or nurse straightaway. Any illness or other type of stress will raise your blood sugar (glucose) levels, even if you are off your food or eating less than usual. People with diabetes are unable to produce more insulin to control the glucose level. The increased glucose level can make you become very lacking in fluid in the body (dehydrated). Acting quickly and following advice helps to keep your glucose levels in the normal range or only slightly high. Because it can sometimes be very difficult to control your blood glucose levels, treatment in hospital may be needed. Hospital treatment may also be needed if you become very dehydrated. What happens to my diabetes when I am unwell? When a person with diabetes is unwell the sugar level in the blood tends to increase. This can happen even with a very mild illness such as the common cold. The blood sugar (glucose) may go up even if you are not eating properly or are being sick (vomiting) or have loose or watery poo (diarrhoea). The increase in blood sugar may make you very lacking in fluid in the body (dehydrated). What should you do when you are unwell? Contact your GP or practice nurse for advice if you are not sure. You may also need treatment for the illness that is making you feel unwell. If you check your blood sugar (glucose) levels then these checks should be more regular. A practice nurse or district nurse can help with checking blood glucose levels, especially if you don't usually check them regularly. Continue eating as normally as possible. If you don't feel like eating, replace your solid food with soup, milk, ice cream, fruit juice, sugar or hon Continue reading >>

High Blood Sugar Emergencies

High Blood Sugar Emergencies

Blood sugar levels that are too high (hyperglycemia) can quickly turn into a diabetic emergency without quick and appropriate treatment. The best way to avoid dangerously high blood sugar levels is to self-test to stay in tune with your body, and to stay attuned to the symptoms and risk factors for hyperglycemia. Extremely high blood sugar levels can lead to one of two conditions—diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS; also called hyperglycemic hyperosmolar nonketotic coma). Although both syndromes can occur in either type 1 or type 2 diabetes, DKA is more common in type 1, and HHNS is more common in type 2. Diabetic Ketoacidosis (DKA) Ketoacidosis (or DKA) occurs when blood sugars become elevated (over 249 mg/dl, or 13.9 mmol/l) over a period of time and the body begins to burn fat for energy, resulting in ketone bodies in the blood or urine (a phenomenon called ketosis). A variety of factors can cause hyperglycemia (high blood glucose), including failure to take medication or insulin, stress, dietary changes without medication adjustments, eating disorders, and illness or injury. This last cause is important, because if illness brings on DKA, it may slip by unnoticed, since its symptoms can mimic the flu (aches, vomiting, etc.). In fact, people with type 1 diabetes are often seeking help for the flu-like symptoms of DKA when they first receive their diagnosis. Symptoms of diabetic ketoacidosis may include: fruity (acetone) breath nausea and/or vomiting abdominal pain dry, warm skin confusion fatigue breathing problems excessive thirst frequent urination in extreme cases, loss of consciousness DKA is a medical emergency, and requires prompt and immediate treatment. A simple over-the-counter urine dipstick test (e.g., Keto Continue reading >>

High Blood Sugars (ketoacidosis)

High Blood Sugars (ketoacidosis)

Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome Severe high blood sugars, ketosis (the presence of ketones prior to acidification of the blood), and ketoacidosis (DKA) are serious and potentially life-threatening medical problems which can occur in diabetes. High blood sugars become life-threatening in Type 1 or long-term Type 2 diabetes only when that person does not receive enough insulin from injections or an insulin pump. This can be caused by skipping insulin or not receiving enough insulin when large amounts are required due to an infection or other major stress. Ketoacidosis surprisingly occurs almost as often in Type 2 diabetes as it does in Type 1. However, people with Type 2 diabetes also encounter another dangerous condition called hyperglycemic hyperosmolar syndrome, which is roughly translated as thick blood due to very high blood sugars. Here, coma and death can occur simply because the blood sugar is so high. The blood will have ketones at higher levels but does not become acidotic. HHS usually occurs with blood sugar readings above 700 mg/dl (40 mmol) as the brain and other functions begin to shut down. When insulin levels are low, the body cannot use glucose present at high levels in the blood. The body then starts burning excessive amounts of fat which causes the blood to become acidic as excess ketone byproducts are produced. Even though the blood pH which measures acidity only drops from its normal level of 7.4 down to 7.1 or 7.0, this small drop is enough to inactivate enzymes that depend on a precise acid-base balance to operate. High blood sugars and ketoacidosis can be triggered by: not taking insulin severe infection severe illness bad insulin In Type 1 diabetes, ketoacidosis often occurs under the duress of an infection, and is also freque Continue reading >>

What Are Ketones And Their Tests?

What Are Ketones And Their Tests?

A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>

Ketone Testing: What You Need To Know

Ketone Testing: What You Need To Know

What are ketones? Why should you test for ketones? How do you test for ketones? And what should you do when you find ketones? What are ketones? Ketones are produced when the body burns fat for energy or fuel. They are also produced when you lose weight or if there is not enough insulin to help your body use sugar for energy. Without enough insulin, glucose builds up in the blood. Since the body is unable to use glucose for energy, it breaks down fat instead. When this occurs, ketones form in the blood and spill into the urine. These ketones can make you very sick. How can I test for ketones? You can test to see if your body is making any ketones by doing a simple urine test. There are several products available for ketone testing and they can be purchased, without a prescription, at your pharmacy. The test result can be negative, or show small, moderate, or large quantities of ketones. When should I test for ketones? Anytime your blood glucose is over 250 mg/dl for two tests in a row. When you are ill. Often illness, infections, or injuries will cause sudden high blood glucose and this is an especially important time to check for ketones. When you are planning to exercise and the blood glucose is over 250 mg/dl. If you are pregnant, you should test for ketones each morning before breakfast and any time the blood glucose is over 250 mg/dl. If ketones are positive, what does this mean? There are situations when you might have ketones without the blood glucose being too high. Positive ketones are not a problem when blood glucose levels are within range and you are trying to lose weight. It is a problem if blood glucose levels are high and left untreated. Untreated high blood glucose with positive ketones can lead to a life-threatening condition called diabetic ketoacidosis Continue reading >>

Euglycemic Diabetic Ketoacidosis, A Misleading Presentation Of Diabetic Ketoacidosis

Euglycemic Diabetic Ketoacidosis, A Misleading Presentation Of Diabetic Ketoacidosis

Go to: Introduction Hyperglycemia and ketosis in diabetic ketoacidosis (DKA) are the result of insulin deficiency and an increase in the counterregulatory hormones glucagon, catecholamines, cortisol, and growth hormone. Three processes are mainly responsible for hyperglycemia: increased gluconeogenesis, accelerated glycogenolysis, and impaired glucose utilization by peripheral tissues. This might also be augmented by transient insulin resistance due to hormone imbalance, as well as elevated free fatty acids.[1] DKA is most commonly precipitated by infections. Other factors include discontinuation of or inadequate insulin therapy, pancreatitis, myocardial infarction, cerebrovascular accident, and illicit drug use. The diagnostic criteria of DKA, established by the American Diabetic Association, consists of a plasma glucose of >250 mg/dL, positive urinary or serum ketones, arterial pH of <7.3, serum bicarbonate <18 mEq/L, and a high anion gap. The key diagnostic feature of DKA is elevated circulating total blood ketone concentration. Hyperglycemia is also a key diagnostic criterion of DKA; however, a wide range of plasma glucose levels can be present on admission. Continue reading >>

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