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Ketones With Low Blood Sugar

Child Health Library

Child Health Library

Topic Overview Diabetes-related blood sugar levels When you have diabetes, you may have high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) from time to time. A cold, the flu, or other sudden illness can cause high blood sugar levels. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. Insulin and some types of diabetes medicines can cause low blood sugar levels. Learn how to recognize and manage high and low blood sugar levels to help you avoid levels that can lead to medical emergencies, such as diabetic ketoacidosis or dehydration from high blood sugar levels or loss of consciousness from severe low blood sugar levels. Most high or low blood sugar problems can be managed at home by following your doctor's instructions. You can help avoid blood sugar problems by following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise. Home blood sugar testing will help you determine whether your blood sugar is within your target range. If you have had very low blood sugar, you may be tempted to let your sugar level run high so that you do not have another low blood sugar problem. But it is most important that you keep your blood sugar in your target range. You can do this by following your treatment plan and checking your blood sugar regularly. Sometimes a pregnant woman can get diabetes during her pregnancy. This is called gestational diabetes. Blood sugar levels are checked regularly during the pregnancy to keep levels within a target range. Children who have diabetes need their parents' help to keep their blood sugar levels in a target range and to exercise safely. Be sure that children learn the symptoms of both high and low blood sugar so they can tell others wh Continue reading >>

What Is Diabetes In Pregnancy?

What Is Diabetes In Pregnancy?

Having diabetes means that there is too much sugar (glucose) in your blood. Some women have diabetes before they get pregnant. Others start having it during pregnancy. Diabetes that starts during pregnancy is called gestational diabetes. If you had diabetes before you became pregnant, it may get harder for you to control your sugar levels during pregnancy. Pregnancy can make both high and low blood sugar levels happen more often. It can make diabetic eye, kidney, heart, blood vessel, and nerve problems worse. You may need to change your insulin dosage. If you were not using insulin before the pregnancy, you may need to use it while you are pregnant. If you develop diabetes during pregnancy, you may need to start a special diet. You may need to have insulin shots or take a pill to help control your blood sugar. If diabetes is not treated well before and during pregnancy, and your sugars are poorly controlled, these problems might occur: The high sugar levels in your blood might cause the baby to get too big before birth. Very large babies tend to have more problems. Babies who are very large or have other problems may need to be delivered by C section. If delivered vaginally, a big baby is slightly more likely to have an injury at the time of delivery. The baby might have birth defects, such as problems with the heart, kidney, spine, or brain. Some of these problems may be life threatening. You might have high blood pressure during the pregnancy, which can cause problems for both you and the baby. You may develop ketones in your blood and urine when you have very high blood sugar. This can cause a very serious, life-threatening condition called diabetic ketoacidosis. You might go into labor early. The baby might need to be delivered early. After delivery the baby’s blo Continue reading >>

Diabetes-related High And Low Blood Sugar Levels

Diabetes-related High And Low Blood Sugar Levels

Topic Overview Diabetes-related blood sugar levels When you have diabetes, you may have high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) from time to time. A cold, the flu, or other sudden illness can cause high blood sugar levels. You will learn to recognize the symptoms and distinguish between high and low blood sugar levels. Insulin and some types of diabetes medicines can cause low blood sugar levels. Learn how to recognize and manage high and low blood sugar levels to help you avoid levels that can lead to medical emergencies, such as diabetic ketoacidosis or dehydration from high blood sugar levels or loss of consciousness from severe low blood sugar levels. Most high or low blood sugar problems can be managed at home by following your doctor's instructions. You can help avoid blood sugar problems by following your doctor's instructions on the use of insulin or diabetes medicines, diet, and exercise. Home blood sugar testing will help you determine whether your blood sugar is within your target range. If you have had very low blood sugar, you may be tempted to let your sugar level run high so that you do not have another low blood sugar problem. But it is most important that you keep your blood sugar in your target range. You can do this by following your treatment plan and checking your blood sugar regularly. Sometimes a pregnant woman can get diabetes during her pregnancy. This is called gestational diabetes. Blood sugar levels are checked regularly during the pregnancy to keep levels within a target range. Children who have diabetes need their parents' help to keep their blood sugar levels in a target range and to exercise safely. Be sure that children learn the symptoms of both high and low blood sugar so they can tell others wh Continue reading >>

(rare Causes). Hypoglycemia And Ketotic Hypoglycaemia, January 2016

(rare Causes). Hypoglycemia And Ketotic Hypoglycaemia, January 2016

Information for parents and carers Hypoglycaemia (low blood sugar) and ketotic hypoglycaemia What is hypoglycaemia? Hypoglycemia is having a blood glucose (also known as blood sugar) level that is too low to provide energy for the body's cells. What is glucose? Glucose is a sugar that is made from the breakdown of carbohydrates found in foods. It is the main source of fuel for the body (including the brain). It may be stored in the liver and muscles for later use, but spare glucose is converted to fat. The level of glucose in the blood is controlled by complex hormone and energy pathways. What is a healthy range of blood glucose? The normal range of blood glucose throughout the day and night is around 3.5 – 6 mmols/litre. However, this varies according to a number of factors; your child’s doctor will talk with you about what should be a normal range for him or her. Why is hypoglycemia a concern? The brain depends on glucose, and too little can affect its ability to function. Severe or very prolonged hypoglycemia could result in fits or serious brain injury. We think your child may be at risk of low blood sugar and you will have been given some advice and treatment to prevent this problem. Causes in young children Single episodes: ï€ Sickness and diarrhoea, or another illness that may cause them to not eat enough. ï€ Fasting for a prolonged period of time. ï€ Prolonged exercise with lack of food. Recurrent episodes: ï€ Ketotic hypoglycaemia. ï€ Medications your child may be taking. ï€ Congenital (present at birth) error in energy metabolism or unusual hormone problem Hypoglycemia and ketotic hypoglycaemia What is ketotic hypoglycaemia? A common reason for recurrent episodes of low blood sugar in young children is ketotic hypoglycaemia, whi Continue reading >>

How To Easily Track Your Glucose Ketone Index (gki) On Your Ketogenic Diet

How To Easily Track Your Glucose Ketone Index (gki) On Your Ketogenic Diet

Tracking ketone levels is a large part of success on the ketogenic diet. It helps you know how far you are into ketosis and where we might need to make changes. But did you know that there’s an even better way to step it up a notch? The glucose ketone index is a simple calculation that allows you to find out how ketosis works best for you individually. Without it, you could be in full, high-level ketosis yet still not getting the full benefits. In this post, we’ll be looking at how to easily track your glucose ketone index for different aspects of health along with your ketogenic diet. Basics of the Glucose Ketone Index Here’s what you need to know about the glucose ketone index (GKI): Researchers have used the index in studies on the ketogenic diet, fasting, and more. Additionally, it has been used for tracking changes and progress regarding weight loss, athletic performance, management of metabolic diseases like type 2 diabetes, and even cancer treatment. Now that we’ve covered the basics of what the GKI does, let’s talk about how you can use tracking it to your advantage. Tracking Your Glucose Ketone Index What’s so special about the glucose ketone index is that it lets you track both glucose and ketones at the same time, taking into account how they work together. It’s a way to know your optimal state for addressing all sorts of health conditions. Tracking this number benefits you over simply measuring ketone levels. That’s because even if you’re deeply in ketosis, you could still have high blood glucose levels that throw things off and affect your health. Essentially, it gives you a more full picture of your metabolic health. The numbers you can expect to target depend on your intentions for being in ketosis. Is your goal weight loss, better overa 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 >>

Take Care Of Yourself When Sick Or Under Stress

Take Care Of Yourself When Sick Or Under Stress

When we're stressed, our bodies need extra energy to help us cope and recover. This is true whether bodies are under stress from illness or injury or are dealing with the effects of emotional stress, both good and bad. To meet the demand for more energy, the body responds by releasing into the bloodstream sugar that's been stored in the liver, causing blood sugar levels to rise. In someone without diabetes, the pancreas responds to the rise in blood sugar by releasing enough insulin into the bloodstream to help convert the sugar into energy. This brings blood sugar levels back down to normal. In someone with diabetes, the extra demand usually means needing to take more diabetes medicine (insulin or pills.) To make sure your body is getting enough medicine to help keep your blood sugar levels close to normal, you'll need to test more often when you are: Sick Recovering from surgery Fighting an infection Feeling upset Under more stress than usual Traveling Type 1 Diabetes In people with type 1 diabetes, blood sugar levels rise in response to stress, but the body doesn't have enough insulin to turn the sugar into energy. Instead, the body burns stored fat to meet energy needs. When fat is burned for energy, it creates waste products called ketones. As fat is broken down, ketones start to build up in the bloodstream. High levels of ketones in the blood can lead to a serious condition known as diabetic ketoacidosis (DKA), which can cause a person to lose consciousness and go into a diabetic coma. Type 2 Diabetes In people with type 2 diabetes, the body usually has enough insulin available to turn sugar into energy, so it doesn't need to burn fat. However, stress hormones can cause blood sugar levels to rise to very high and even dangerous levels. People with type 2 diabetes 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 >>

What Is The Ph Of The Blood In A Diabetic Patient When His Glucose Levels Are Appropriate?

What Is The Ph Of The Blood In A Diabetic Patient When His Glucose Levels Are Appropriate?

Diabetes causes your body's pH levels to become more acidic and develop a condition called ketoacidosis, the American Diabetes Association explains. Your body's pH level refers to the acidity or alkalinity of the fluids in your body. Diabetes impairs your body's ability to properly utilize the glucose in your blood. Instead, your body is forced to convert fat into energy through a process that develops into ketoacidosis. Diagnosing ketoacidosis involves testing blood for the presence of ketones, the University of Maryland Medical Center explains. There are two main types of diabetes. Type 1 diabetes is congenital, and its symptoms appear as early as childhood, MayoClinic.com explains. Type 1 diabetes is characterized by your body's inability to produce insulin, the hormone needed for cells to metabolize glucose into energy. Type 2 diabetes is essentially defined by acquired insulin resistance that usually manifests in adulthood. Both types of diabetes cause increased thirst, frequent urination, unexplained weight loss, hypertension and ketoacidosis. Left untreated, both types of diabetes lead to complications that damage your cardiovascular system, kidneys and nerves due to the accumulated glucose in your blood. Complications due to diabetes such as ketoacidosis are fatal if not treated. Ketones are the acidic byproducts of fat breakdown that accumulate when your body uses fat instead of glucose as a source of fuel, MedlinePlus, a service of the National Institutes of Health, explains. As your ketone levels increase, your body becomes more acidic. Ketones are present in both types of diabetes but are generally more typical of type 1 diabetes. Ketones are also sometimes present in urine. Acetone and acetoacetic acid are examples of ketones. Ketoacidosis does not happen o Continue reading >>

Optimal Ketone And Blood Sugar Levels For Ketosis

Optimal Ketone And Blood Sugar Levels For Ketosis

A low carb helps reduce blood sugars and insulin levels and helps with the management of many of the diseases of modern civilisation (e.g. diabetes, heart disease, stroke, cancer, Parkinson’s and Alzheimer’s). We become insulin resistant when our body fat can’t store any more energy. Excess energy is then stored in the liver, pancreas, heart, brain and other organs that are more insulin sensitive. We also see increased levels of energy in our blood in the form of glucose, fat and elevated ketone. Endogenous ketosis occurs when we eat less food than we need. Our insulin and blood sugar levels decrease and ketones rise to supply the energy we need. Exogenous ketosis occurs when we eat lots fat and/or take exogenous ketones. Blood ketones rise, but our insulin levels will also rise because we have an excess of energy coming from our diet. Most of the good things associated with ketosis occur due to endogenous ketosis. Most people following a ketogenic diet over the long term have ketone values lower than what some people consider to be “optimal ketosis”. If your goal is blood sugar control, longevity or weight loss then endogenous ketosis with lower blood sugars and lower ketones is likely a better place to be than chasing higher blood ketones. I have seen a lot of interest and confusion recently from people following a ketogenic about ideal ketone and blood sugar levels. In an effort to try to clear this up, this article reviews blood ketone (BHB), breath ketone (acetone) and blood sugar data from a large number of people who are following a low carb or ketogenic diet to understand what “normal” and “optimal” look like. Many people initiate a low carb diet to manage their blood glucose levels, insulin resistance or diabetes. As shown in the chart below, Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>

For The Love Of Exogenous Ketones!

For The Love Of Exogenous Ketones!

You read that correctly. I love ketones and I am actively pursuing ways to increase my bodies ability to produce them through the use of exogenous ketone supplements. Ketones are a dirty word in the world of diabetes because of the confusion surrounding their appearance as the harbinger of doom through DKA (diabetic ketoacidosis). Unfortunately many healthcare providers actively discourage their diabetic patients from attempting to achieve nutritional ketosis because they don’t fully understand the difference between nutritional ketosis and DKA. That difference is NOT the focus of this post, other than to establish the fact that there IS a difference. It’s important to note that the means of detecting DKA is typically the presence of ketones in the blood. Adding them through exogenous supplementation or nutritional ketosis is useful (I would even argue beneficial), but not without some risk. In case of insulin deficiency (bad pump site, occlusion, skipped dose etc) while in ketosis one would be without the means to clearly identify DKA. You’d only be able to guess based on blood glucose level to infer how insulin deficient you are. The risk can be mitigated through vigilance and attention to insulin dosing but shouldn’t be taken lightly. I’ve recently started using exogenous ketones to help put me into nutritional ketosis more readily and I wanted to report the initial findings since I’ve been asked about them so many times. Up till this point I didn’t feel compelled to spend the time and money on exogenous ketone supplements–which are not cheap! I took the plunge and got some delicious, chocolate-flavored betahydroxybutyrate or (BHB) for short. I am not going to attempt to get into the science behind the impacts of BHB on my blood sugar, energy and meta Continue reading >>

Low Blood Glucose (hypoglycemia)

Low Blood Glucose (hypoglycemia)

Hypoglycemia (said like: hi poe glie SEE mee ah), or low blood glucose, is the most common problem with insulin therapy. Low blood glucose is when the blood glucose falls below 70 mg/dl. Hypoglycemia can happen very quickly. What causes low blood glucose? Not enough carbohydrates eaten Too much insulin given More exercise than normal How do I prevent low blood glucose? The best way to prevent low blood glucose is to take insulin based on the amount of carbohydrates you are eating, your blood glucose level, and your planned activity level. Plan ahead if you know you will be doing more activity than normal. Test your blood glucose regularly. What do I need to be ready for a low blood glucose? Know YOUR signs of low blood glucose. Your family and friends will also need to learn your signs of low blood glucose so they can help you treat it. Always keep some form of sugar with you. Always keep your blood glucose meter with you. Always have a Glucagon Emergency Kit (see page 49). Always wear a medical necklace or bracelet, or carry a medical ID card in your wallet. What are the signs of low blood glucose? Because sugar (glucose) is the main fuel for the brain, a sudden drop in the glucose level can cause the following symptoms: Early Signs Late Signs Signs While Sleeping Shakiness Nervousness Stomach ache Weakness Blurry vision Dizziness Pale skin Sweating Headache Personality change Seizures Confusion Irritability, crankiness Unconsciousness Nightmares Waking up suddenly Sweating; wet clothes or sheets Fast heart beat Can’t fall back to sleep; restless How do I treat low blood glucose with the 15/15 Rule? Step 1: Stop what you are doing if you have any signs of low blood glucose, and check your blood glucose. You may have to: Let your coach know you need a break. Leave cla Continue reading >>

Surviving A Stomach Virus With Type 1 Diabetes

Surviving A Stomach Virus With Type 1 Diabetes

Taking care of someone with diabetes when they’re sick is tough; taking care of yourself when you’re sick and have diabetes is tougher (and not to mention super freaking scary). For those of us living with type 1 diabetes something as small as a stomach virus can quickly become serious if you make the wrong move. Knowing what to do and when to do it is more complicated than you might think. Why is that? Because everyone’s body reacts to a cold or virus differently (heck my own body acts differently every time!) so you need to be prepared for the unpredictability that is stomach virus blood sugar…and since you’re already a T1D you should be a pro at unpredictability. How Illness Affects Blood Sugar The body perceives illness as stress, and when your body is stressed it releases hormones such as cortisol and epinephrine (adrenaline), which raises your blood sugar levels. However, sometimes the illness can lower your blood sugar because you aren’t eating (and have background insulin running) or can’t keep food down (and have just bolused for a meal). So My Blood Sugar Goes A Little Crazy For A Day Or Two, Big Flippin’ Deal Most of the time it really is no big deal, however, being stuck up shits creek (literally) and not having a plan in place is a big flippin’ deal. There are two ways an illness can go really wrong really fast when you’re a type 1 diabetic DKA – Diabetic Ketoacidosis (which is much different than nutritional ketosis – but that’s a post for another time) is when there is a toxic amount of ketones in your blood. So much so that your blood becomes acidic to the point of being fatal. The acidity becomes even more potent when you’re dehydrated, which will happen if you are losing it from both ends and can’t keep anything down (or i Continue reading >>

Tips For Managing Sick Days: High Sugars, Low Sugars And Ketones General Rules:

Tips For Managing Sick Days: High Sugars, Low Sugars And Ketones General Rules:

ï‚· Never omit all insulin even if your child is not eating well. Long acting insulin (Lantus or Levemir) or basal rate (if you are on a pump) is still needed. ï‚· Give lots of fluids. o If the blood sugar is 200 or higher, give fluids with no carbs like water or diet soda. o If the blood sugar is less than 200, give carb-containing fluids like Gatorade, Pedialyte and regular soda. (The idea is to bring the blood sugar to a safe range so you can safely give insulin to prevent or get rid of ketones.) ï‚· Check blood sugars every 3 hours including at night throughout the illness and write them down. If they are high, look below for what to do next. ï‚· Check for ketones at least 2 times a day. If it is positive, look below for what to do next. ï‚· Sometimes a medication is used to help decrease the vomiting. This can help with keeping the fluids down. You can discuss this with the clinic (or on-call doctor if it is after hours) if you have questions. What to do with insulin? ï‚· Do NOT skip the long acting insulin or suspend the insulin pump even if your child is not eating well or vomiting. You may decrease the dose by 10% if sugars are below 100 or if he/she is feeling sick and are unable to eat. ï‚· If he/she is able to eat, cover all carbs as usual with the fast acting insulin (Novolog/Humalog/Apidra). ï‚· If he/she is vomiting, try sips of fluids. Do NOT cover carbs with insulin if you think he/she may throw up. ï‚· If he/she has ketones, follow the ketone protocol below. What to do with high blood sugars? ï‚· Check sugars every 3 hours including at night. ï‚· Check for ketones if your child is sick or blood sugar is above 300. ï‚· If there are ketones, see the chart on page 3. ï‚· If there are no ketones, give fast Continue reading >>

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