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Ketones With Low Blood Sugar

Type 1 Diabetes

Type 1 Diabetes

Certainly a low carb approach doesn’t work with Type 1’s, right? What about the dangerous risks of hypoglycemia? Actually, this thinking is repeated over and over. Nothing could be further from the truth. In fact, those using a low carbohydrate high healthy fat (LCHF) approach have much more stable blood sugars, some nearly eliminating hypoglycemic episodes altogether. It really makes perfect sense. Why this reasoning is shunned, defies logic. Think about it…less (fast acting, blood-sugar-spiking) carbs, less insulin, less hypos. Before we go further in this post, I’d like you to read this powerfully compelling account of Dr. Keith Runyan, MD, a Nephrologist, who is a Type 1, and who successfully uses a carb restricted approach to manage his diabetes. Please read his story (link below). There is no way I could do this story justice in fewer words. The entire article is needed to understand its full impact. Afterwards, I would recommend his accompanying video. Nutritional Ketosis vs Diabetic Ketoacidosis Much of the backlash from mainstream beliefs regarding the use of carb restriction with Type 1’s stems from the lack of understanding about the difference between nutritional ketosis and diabetic ketoacidosis. I’m going to quote directly from Diabetes Daily Website. Here is the content of their article entitled “Why DKA and Nutritional Ketosis Are Not The Same”…(read the full article HERE) “There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstanding lie in the areas of: ketones that are produced in low-carb diets of generally less than 50g of carbs per day, which is low enough to put a person into a state of “nutritional ketosis.” ketones that are produced when a diabetic is in a state of Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>

The Liver & Blood Sugar

The Liver & Blood Sugar

During a meal, your liver stores sugar for later. When you’re not eating, the liver supplies sugar by turning glycogen into glucose in a process called glycogenolysis. The liver both stores and produces sugar… The liver acts as the body’s glucose (or fuel) reservoir, and helps to keep your circulating blood sugar levels and other body fuels steady and constant. The liver both stores and manufactures glucose depending upon the body’s need. The need to store or release glucose is primarily signaled by the hormones insulin and glucagon. During a meal, your liver will store sugar, or glucose, as glycogen for a later time when your body needs it. The high levels of insulin and suppressed levels of glucagon during a meal promote the storage of glucose as glycogen. The liver makes sugar when you need it…. When you’re not eating – especially overnight or between meals, the body has to make its own sugar. The liver supplies sugar or glucose by turning glycogen into glucose in a process called glycogenolysis. The liver also can manufacture necessary sugar or glucose by harvesting amino acids, waste products and fat byproducts. This process is called gluconeogenesis. When your body’s glycogen storage is running low, the body starts to conserve the sugar supplies for the organs that always require sugar. These include: the brain, red blood cells and parts of the kidney. To supplement the limited sugar supply, the liver makes alternative fuels called ketones from fats. This process is called ketogenesis. The hormone signal for ketogenesis to begin is a low level of insulin. Ketones are burned as fuel by muscle and other body organs. And the sugar is saved for the organs that need it. The terms “gluconeogenesis, glycogenolysis and ketogenesis” may seem like compli 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 >>

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 >>

Diabetic Coma Symptoms

Diabetic Coma Symptoms

A diabetic coma is one of the most life-threatening complications of diabetes. The main symptom is unconsciousness. A diabetic coma can be the result of having a blood glucose level that is too high (hyperglycemia) or a blood glucose level that is too low (hypoglycemia). The diabetic in a diabetic coma is unconscious and can die if the condition is not treated. Symptoms of Diabetic Coma Before you lapse into a diabetic coma, there are usually warning signs of blood sugar levels that are too low or blood sugar levels that are too high. For example, if the blood sugar is too high, the you may experience tiredness, abdominal pain, shortness of breath, increased urination, increased thirst, a rapid heart rate, a dry mouth, and a fruity smell to your breath. If the blood sugar is too low, you may experience signs and symptoms of hypoglycemia, including weakness, tiredness, anxiety, tremulousness, nervousness, nausea, confusion, problems communicating, light-headedness, hunger, or dizziness. If you have had diabetes for many years, you may not have many symptoms of low blood sugar and won’t know you have the condition prior to falling into a coma. If you suspect that you have either high blood sugar or low blood sugar, you need to check your blood glucose levels and do what your doctor has recommended for you to treat the disease. If you don’t feel better after trying home remedies, you need to call 911 and get some kind of emergency care. Causes of Diabetic Coma The main cause of a diabetic coma is an extremely high blood sugar or an extremely low blood sugar. The following medical conditions can cause a diabetic coma: Diabetic hyperosmolar syndrome. This is a condition in which the blood sugar is as high as 600 mg/d: or 33.3 mmol per liter. There are no ketones in the u Continue reading >>

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>

Ketones And Exercise – What You Need To Know

Ketones And Exercise – What You Need To Know

A researcher on diabetes and exercise describes why exercise elevates risk of DKA for people with Type 1 diabetes. In a new set of guidelines for Type 1 diabetes and exercise, I and my fellow researchers warn that people with Type 1 diabetes need to monitor for elevated levels of ketones during exercise. If you have Type 1 and exercise regularly, testing for ketones could save your life. Ketones develop in our bodies when we mobilize fat as fuel. Fat is an important energy source that is used by the body at rest and during exercise. Ketones are a general term in medicine used to describe the three main ketone bodies that the liver produces – acetoacetate, beta-hydroxybutyrate, and acetone. Read “Too Many with Type 1 Don’t Test for Ketones.” sponsor Ketone bodies help fuel the brain and skeletal muscle during times of prolonged fasting or starvation, so in a way ketones are very important for survival. We actually have enough stored fat to generate energy for days, but this can cause a number of metabolic problems, the most important of which is ketoacidosis. In Type 1 diabetes, ketone levels can rise even without starvation, if insulin levels drop too much and levels of other hormones like glucagon and catecholamines rise. This rise in ketone levels in diabetes can cause a life-threatening condition called diabetic ketoacidosis (DKA). Read “How DKA Happens and What to Do About it.” The symptoms of ketoacidosis include: A lack of energy, weakness, and fatigue Nausea and vomiting, stomach pain, decreased appetite Rapid weight loss Decreased perspiration, foul or fruity breath Altered consciousness, mild disorientation or confusion Coma sponsor The reasons for developing high ketone levels in Type 1 diabetes include: Missed insulin injections Failure of insulin Continue reading >>

Low Blood Sugar / Ketones

Low Blood Sugar / Ketones

So! I was diagnosed with GD. I have lost 151 lbs and maintained that loss for a yr and a half prior to being pregnant. I was prediabetic before I lost my weight. I had a very proud GP tell me I was no longer prediabetic. I pulled out my old monitor and got new strips and bought some ketostix. I'm frequently low blood sugar because I watch my carbs and refined sugar. I met with the internal specialist and he more or less talked at me vice with me. He reviewed my numbers and actually asked to test my monitor against his, which they were .01 off and then told me that I might be poisoning my body with ketones so he was going to give me ketostix. To which I responded that I already had some and the three times I tested I was negative. Went to the diabetes patient info and they too freaked out about my low blood sugar and said I needed more starches and then told me I had a morbid fear of gaining weight with one breath and gave me shit for my current weight gain in another one. I've decided to play their game for a while and I'm eating what they want but now I'm getting ketones with 3.8 and 4.2 but never did with those numbers before. Anyone have anything they can offer? I'm going between crying and anger that I'm under a microscope when I feel I was eating healthy before and I'm concerned I'm being put in a standardized box of once size fits all! Also, I am not seeing my doc of 8 yrs because she doesn't deliver babies but she told me I can come back anytime I needed her so I'm going to try my hardest to see her on Monday as the one she referred me to didn't listen EITHER! Continue reading >>

Ketones…what Are They And What Do They Mean?

Ketones…what Are They And What Do They Mean?

Ketones are produced in the blood from the break down of fat. Fat is used for fuel when the body can’t burn glucose. Situation # 1: The body needs more insulin In people with type 1 diabetes, ketones are made because there is a relative lack of insulin, which is needed to burn glucose for fuel. In this situation, their blood sugars are usually high. So some meters will give a prompt to test ketones if the reading is over 15 mmol/L. In this case, ketones are a sign of danger - a sign that the body needs more insulin. A build up of ketones can cause a condition called “ketoacidosis” which can be a life-threatening situation. The body operates within a very narrow range of pH or acidity. Ketones change the delicate pH balance in the blood and cause people to go into a coma and even die if this condition is not treated. The usual cause is forgetting to take insulin or perhaps taking insulin that is no longer active (like if it gets too hot or too cold). Another cause can be the flu or any acute illness that make the body need more insulin. People on an insulin pump may be particularly prone to going into ketoacidosis faster than people on injections as once the pump is disconnected (or if the site is not working) there is no body “store” of insulin. Dehydration for any cause can also tip people into ketoacidosis, for example, vomiting with the flu. Once ketones build up, the body tries to compensate by increasing the breathing rate. The breath as it breathes off the ketones has a “fruity” smell. Often there will be stomach pain and vomiting. This last symptom can be misunderstood as the “flu” and ignored. Once this happens or if the sugars and ketones remain high, it is critical to be treated in a hospital setting. Sometimes a “correction” scale of ext Continue reading >>

Ketoacidosis: A Complication Of Diabetes

Ketoacidosis: A Complication Of Diabetes

Diabetic ketoacidosis is a serious condition that can occur as a complication of diabetes. People with diabetic ketoacidosis (DKA) have high blood sugar levels and a build-up of chemicals called ketones in the body that makes the blood more acidic than usual. Diabetic ketoacidosis can develop when there isn’t enough insulin in the body for it to use sugars for energy, so it starts to use fat as a fuel instead. When fat is broken down to make energy, ketones are made in the body as a by-product. Ketones are harmful to the body, and diabetic ketoacidosis can be life-threatening. Fortunately, treatment is available and is usually successful. Symptoms Ketoacidosis usually develops gradually over hours or days. Symptoms of diabetic ketoacidosis may include: excessive thirst; increased urination; tiredness or weakness; a flushed appearance, with hot dry skin; nausea and vomiting; dehydration; restlessness, discomfort and agitation; fruity or acetone smelling breath (like nail polish remover); abdominal pain; deep or rapid breathing; low blood pressure (hypotension) due to dehydration; and confusion and coma. See your doctor as soon as possible or seek emergency treatment if you develop symptoms of ketoacidosis. Who is at risk of diabetic ketoacidosis? Diabetic ketoacidosis usually occurs in people with type 1 diabetes. It rarely affects people with type 2 diabetes. DKA may be the first indication that a person has type 1 diabetes. It can also affect people with known diabetes who are not getting enough insulin to meet their needs, either due to insufficient insulin or increased needs. Ketoacidosis most often happens when people with diabetes: do not get enough insulin due to missed or incorrect doses of insulin or problems with their insulin pump; have an infection or illne Continue reading >>

All About Hypoglycemia (low Blood Sugar)

All About Hypoglycemia (low Blood Sugar)

Hypoglycemia refers to an abnormally low level of sugar, or glucose, in the blood. Hypoglycemia is not a disease in itself, it is a sign of a health problem. The brain uses a lot of energy and needs glucose to function. Because the brain cannot store or manufacture glucose, it needs a continuous supply. Signs of low blood sugar include hunger, trembling, heart racing, nausea, and sweating. Hypoglycemia is commonly linked with diabetes, but many other conditions can also cause low blood sugar. This article will discuss the causes, diagnosis, and treatment of hypoglycemia, and the difference between hypoglycemia and hyperglycemia. We will also look at how to prevent it. Here are some key points about hypoglycemia. More detail is in the main article. Hypoglycemia is not a disease but a symptom of another condition. Early symptoms include hunger, sweating, and trembling. A common cause is diabetes. Alcohol abuse and kidney disorders can also lower blood sugar levels. What is hypoglycemia? Hypoglycemia is a condition where there is not enough glucose, or sugar, in the blood. Levels of blood sugar are below 4 mmol/L (72mg/dL). Adults and children with mild hypoglycemia may experience the following early symptoms: hunger tremor or trembling sweating irritability a pale face heart palpitations accelerated heart rate tingling lips dizziness weakness Severe hypoglycemia is sometimes called diabetic shock. It may involve: concentration problems confusion irrational and disorderly behavior, similar to intoxication inability to eat or drink Complications If a person does not take action when symptoms of hypoclycemia appear, it can lead to: A person who regularly experiences hypoglycemia may become unaware that it is happening. They will not notice the warning signs, and this can lea Continue reading >>

Ketones — The 6 Must-knows

Ketones — The 6 Must-knows

WRITTEN BY: Kyla Schmieg, BSN, RN Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and Type 1 Diabetic, working on the same unit she was diagnosed at 26 years ago. 1 – What are ketones? Ketones are chemicals that build up when your body starts to burn fat for energy. The most common cause of ketones in diabetics is insulin deficiency. Without enough insulin, glucose builds up in the blood stream and can’t enter cells. The cells then burn fat instead of glucose. This results in ketones forming in the blood and eventually spilling into urine. 2 – Why can ketones be dangerous? Having ketones can indicate that your body needs more insulin. (Always monitor your blood sugar levels to know how much insulin you need.) If you have a build up of ketones, this can lead to Diabetic Ketoacidosis (DKA). Signs of DKA include moderate or large ketones, nausea, vomiting, abdominal pain, fruity or acetone (think nail polish remover) breath, rapid breathing, flushed skin, and lack of energy. If left untreated, it can lead to a serious and life-threatening diabetic coma or death. High levels of ketones are toxic to the body and if you’re experiencing these, you should seek out medical attention. 3 – When should you check for ketones? You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold. 4 – Can you get ketones with a high blood sugar? Ketones typically accompany high blood sugar. They indicate that your body needs more insulin. Most often if your body needs more insulin, it means you probably have a high blood sugar. Also, when an illness is present, your body releases hormones in response to the stress. These hormones Continue reading >>

Monitoring Ketone And Blood Glucose Levels On A Low Carb Diet

Monitoring Ketone And Blood Glucose Levels On A Low Carb Diet

By Mary T. Newport M.D. While it is not necessary to measure ketone levels, many people who make the change to a low carb, ketogenic diet and/or use ketone salts would like to have some positive proof that their ketone levels are, in fact, elevated. When transitioning from a higher carb to a low carb, ketogenic type diet, it can take several days to begin to see an increase in ketone levels and the ketone level may continue to rise for two or three weeks before it levels off. The ketone level can fluctuate somewhat throughout the day and can vary considerably from person to person. Using ketone salts, such as Prüvit KETO//OS® or KETO//OS Max, as a supplement can give you a jump start on getting into ketosis and increase ketone levels within 30 to 60 minutes of taking the product. Using coconut oil and MCT oil as part of the diet can help increase and sustain ketone levels as well. There are several ways available to measure ketone levels in urine, blood or by using a breath analyzer. When blood levels of ketones become elevated, the excess ketones will filter out of the blood into the urine. Urine ketone test strips were originally developed for diabetics to help determine if they are going into diabetic ketoacidosis when the blood sugar is elevated. There are a number of companies that sell urine test strips that change color when ketone levels are elevated – usually the deeper the color, the higher the ketone level. This will not tell you what your actual blood ketone level is but can give you a rough idea of whether you are in ketosis or not. However, one of the drawbacks to using urine test strips is that they only measure the ketone acetoacetate and not beta-hydroxybutyrate, which tends to be much more elevated than acetoacetate during ketosis. Also, Prüvit ke Continue reading >>

> Handling Diabetes When You're Sick

> Handling Diabetes When You're Sick

Whether your head feels like it's stuffed with cotton because you have a cold or you're spending a lot of time on the toilet because of a stomach bug, being sick is no fun for anyone. For people with diabetes, being sick can also affect blood sugar levels. The good news is that taking a few extra precautions can help you keep your blood sugar levels under control. When you get sick — whether it's a minor illness like a sore throat or cold or a bigger problem like dehydration or surgery — the body perceives the illness as stress. To relieve the stress, the body fights the illness. This process requires more energy than the body normally uses. On one hand, this is good because it helps supply the extra fuel the body needs. On the other hand, in a person with diabetes, this can lead to high blood sugar levels. Some illnesses cause the opposite problem, though. If you don't feel like eating or have nausea or vomiting, and you're taking the same amount of insulin you normally do, you can develop blood sugar levels that are too low. Blood sugar levels can be very unpredictable when you're sick. Because you can't be sure how the illness will affect your blood sugar levels, it's important to check blood sugar levels often on sick days and adjust your insulin doses as needed. Your diabetes management plan will help you know what to do when you're sick. The plan might tell you: how to monitor your blood glucose levels and ketones when you're sick which medicines are OK to take what changes you might make to your food and drink and diabetes medications when to call your doctor In addition, people with diabetes should get the pneumococcal vaccine, which protects against some serious infections. You should also get a flu shot every year. These vaccines may help you keep your dia Continue reading >>

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