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What Happens When You Have Ketones In Your Urine?

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a serious condition characterized by high blood sugar (hyperglycemia), low insulin, and the presence of moderate to large amounts of ketones in the blood. It's a medical emergency that requires treatment in a hospital. If not treated in a timely fashion, ketoacidosis can lead to coma and death. While diabetic ketoacidosis (or DKA) is much more common among people with type 1 diabetes, it can also occur in people with type 2 diabetes, so ketone monitoring is something everyone with diabetes should understand. Diabetic Ketoacidosis Symptoms Signs and symptoms of ketoacidosis include: Thirst or a very dry mouth Frequent urination Fatigue and weakness Nausea Vomiting Dry or flushed skin Abdominal pain Deep breathing A fruity breath odor What Are Ketones? Ketones, or ketone bodies, are acidic byproducts of fat metabolism. It's normal for everyone to have a small amount of ketones in the bloodstream, and after a fast of 12 to16 hours, there may be detectable amounts in the urine. As is the case with glucose, if blood levels of ketones get too high, they spill over into the urine. An elevated level of ketones in the blood is known as ketosis. People who follow low-carbohydrate diets often speak of ketosis as a desirable state — it's evidence that their bodies are burning fat, not carbohydrate. But the level of ketosis that results from low carbohydrate consumption isn't harmful and is much lower than the level seen in diabetic ketoacidosis. When Should Ketones Be Monitored? Ketone monitoring is less of a concern for people with type 2 diabetes than for those with type 1 diabetes. This is because most people with type 2 diabetes still make some of their own insulin, making diabetic ketoacidosis less likely to develop. Nonetheless, people with type 2 d Continue reading >>

High Blood (hyperglycemia) And Ketones

High Blood (hyperglycemia) And Ketones

Hyperglycemia (said like: hi per glie SEE mee ah) is also called high blood glucose. It happens when blood glucose numbers are higher than 120 mg/dl. What causes high blood glucose? Eating more carbohydrates than you calculated for your insulin dose Not enough insulin is taken Stress Illness How do I prevent high blood glucose? Count your carbohydrate closely. Give the right insulin dose based on your meal and blood glucose number. Change the insulin doses when you see a pattern of high blood glucose levels. Give insulin for all the carbohydrate you eat. How will I feel when my blood glucose is high? Thirsty Need to go to the bathroom a lot Need to get up at night to go to the bathroom Tired Dry lips and mouth What should I do if my blood glucose is high? • Drink fluids that do not have carbohydrates. Try to drink 1 full glass (8 ounces) every 30 to 60 minutes. • Check your urine or blood for ketones if blood glucose is higher than 300 mg/dl. Why would I have ketones? You need glucose in every cell in your body to use for energy. Your body needs glucose and insulin in your blood. When there is not enough glucose or not enough insulin, your cells will not have glucose to use for energy. When cells do not have glucose to use for energy: The body starts to use fat for energy. --> Ketones are made when fat is used for energy. --> Ketones are in the blood and in the urine. --> Ketones are acids. --> What 2 things does your body need to prevent ketones? _________________________________________________________ _________________________________________________________ How do I check for ketones? Collect urine in a cup. Dip the test strip into the cup (Picture 1). Remove the test strip from the urine. Wait 15 seconds. Match the color on the strip to the colors on the bottle Continue reading >>

Hypo & Hyper Management

Hypo & Hyper Management

Home blood glucose monitoring The aim of treatment is to try to maintain your glucose level to as near a “non -diabetic” range as possible. In general terms this means to aim towards 4 -7 mmol/l before meals, and around 8 mmol/l if testing 2 hours after meals. This can be difficult at times as you are trying to mimic what the body had previously done of its own accord, and your readings may vary depending your carbohydrate intake, exercise and many other daily factors. This management takes time and practice and requires that you work closely with your doctor, diabetes nurse specialist and other members of your diabetes care team. They’ll guide you to maintain the best possible blood glucose control. HbA1c This is known as the “long term test” and is performed by a medical professional. This is a measure of your blood glucose control over a period of the previous approx 6 -8 weeks. It is a very good indicator of your overall control of your condition despite the odd high or low readings you may have had during that time. Hyperglycaemia or Hypoglycaemia This can be caused by high or low glucose levels. High blood glucose levels, also know as Hyperglycaemia or Hyper. You will notice that your blood glucose level may be higher if you: Are not taking enough insulin Miss or forget to take your insulin ( or take a lower amount in error) Eat more carbohydrate foods than usual Are less active than usual Are under stress Have an illness eg cold flu, infection (see further info re illness below) Sometimes it may be difficult to find a reason Low blood glucose levels, also known as Hypoglycaemia or Hypo. You may notice that your blood glucose may go to low (ie. Under 4 mmol/l) if you: Take too much insulin Eat less carbohydrate than usual Leave too long between meals Do Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

Duck Dodgers October 14, 2014 Peter, An article by Per Wikholm was published in this month’s LCHF Magasinet, where Per demonstrates that the Inuit could not have been in ketosis given that the scientific literature is abundantly clear, over and over again, that the Inuit consumed too much protein, and more importantly, Per debunks Stefansson’s claims for high fat with writing from his own books—Stef admitted in the pemmican recipes that Arctic caribou was too lean to make pemmican that supported ketosis. The most popular LCHF bloggers in Sweden, Andreas Eenfeldt/Diet Doctor and Annika Dahlquist have reluctantly agreed with Per’s findings—admitting that the Inuit were likely not ketogenic from their diet. I’ve put together a comprehensive review of the scientific literature regarding the Inuit, encompassing over two dozen studies, spanning 150 years, with references from explorers, including Stefansson. In the comments section of that post, Per gives a brief overview of how he was able to prove Stefansson’s observations on high fat intake were flawed. The post is a review of all the available literature that I could find (over two dozen studies). But, the literature certainly does not in any way support ketosis from the Inuit diet due to such high protein consumption. As Per (and Stefansson) points out, the caribou is too lean and as the many quotes show, the Inuit were saving their blubber and fat for the long dark Winter to power their oil lamps and heat their igloos. Again and again, we see that in the literature, as even Stefansson admits this. As far as glycogen is concerned, their glycogen intake is probably not worth scrutinizing given the well-documented high protein consumption in every published study. It really is besides the point. But, interest Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) is a dangerous and potentially life threatening complication of diabetes, with thousands of preventable cases each year. DKA most commonly happens in people with Type 1 Diabetes although it occasionally occurs in people with insulin-treated Type 2 Diabetes. DKA occurs when there is persistently high glucose and a severe lack of insulin. 10,434 people with Type 1 diabetes hospitalised at least once during 2011-12 ¹ 9% of children experienced DKA in 1 year ² Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period, with the first sign often being hyperglycemia. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration Deep laboured breathing (called kussmaul breathing) Confusion and sometimes even coma Click here to download the full DKA Information Brochure What are Ketones? Ketones are the by-product of fat metabolism. Ketones can provide the body with energy when glucose is not available. As you know, in order to derive energy from the carbohydrates in the foods that we eat, the body needs insulin. Insulin is the key that unlocks the body’s cells in order to allow glucose to enter to provide energy. In the absence of sufficient insulin, glucose cannot enter the cells and the glucose levels build up in the blood. Without insulin, the body begins to metabolize fat and produces ketones. Ketones can be very dangerous when the blood glucose level is high. If the blood glucose and ketones levels continue to rise, one can get very sick very quickly. The person begins to get dehydrated and acidotic, meaning that the body loses water and salts and the pH falls with a build up of acids, the ketones, developing DKA. What are blood ketones versus urine ketones You may have heard about or learned how to check urine ketones 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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>

What Are The Dangers Of A Sugar Count Over 500?

What Are The Dangers Of A Sugar Count Over 500?

Blood sugar control is a critical aspect of diabetes management. People without diabetes typically have fasting blood sugar readings below 100 milligrams per deciliter. If you are diabetic, your doctor sets an individualized blood sugar goal that you aim for with the help of an individualized treatment regimen. A reading higher than your target indicates your blood sugar is not under control, and having a reading over 500 is a medical emergency. Your body needs glucose to function properly, but it's unhealthy for high levels to circulate in your bloodstream. The hormone insulin regulates blood sugar by allowing glucose to get into your cells. Typically, blood sugar is considered high when it's 160 milligrams per deciliter or above your glucose target, notes the Joslin Diabetes Center. Your doctor may need to adjust your treatment plan if your glucose remains above 180 milligrams per deciliter for three consecutive days. If glucose stays elevated for a long time, it can affect your eyes, kidneys and heart. Ketoacidosis A dangerously high blood sugar level increases your risk for diabetes-related ketoacidosis. When glucose circulates in your bloodstream and can't get into your cells, your cells don't get the energy they need. To compensate, your body begins to burn fat for fuel, producing acids called ketones. These acids build up in your bloodstream and can poison your body when levels get too high. This happens when your body doesn't have enough insulin and is more common with Type 1 diabetes. The American Diabetes Association recommends checking your urine for ketones when your glucose is higher than 240 milligrams per deciliter. Hyperosmolar Syndrome Your kidneys typically excrete extra glucose to help compensate for high blood sugar levels, but when glucose is extrem 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 >>

Pregnancy If You Have Diabetes

Pregnancy If You Have Diabetes

If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. 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 >>

High Blood Glucose (hyper) & Type 1 Diabetes

High Blood Glucose (hyper) & Type 1 Diabetes

Key points Hyperglycaemia happens from time to time to all people who have diabetes. Hyperglycaemia is a major cause of many of the complications that happen to people who have diabetes. For this reason, it’s important to know what hyperglycaemia is, what its symptoms are, and how to treat it. Untreated hyperglycaemia diabetes can lead to a life threatening condition called diabetic ketoacidosis (DKA). If you have Type 1 diabetes, you will often develop high blood glucose levels. Managing your Type 1 diabetes is a lot to do with developing problem solving skills and learning to use them. Remember that if your body is producing its own insulin, it alters the amount all the time (minute by minute). When you have Type 1 diabetes you have to do this consciously by using your knowledge and making sensible choices. Your diabetes nurse educator can help you learn the skills you need to do this. Some people prefer to get guidance on any of the choices they make. Everyone is different. If you are making choices you haven’t previously put into practice, get advice and support from your diabetes team before and while you make the changes. The effects of high blood glucose levels are probably what first led you to visit the doctor when your diabetes was diagnosed. Normally the human body keeps its blood glucose level very stable (between 4mmol/L – 7.5mmol/L). The body has various systems (regulated by hormones such as insulin and glucagon) for keeping the blood glucose level in this range. This doesn’t happen if you have Type 1 diabetes. Symptoms of high blood glucose levels Feeling thirsty Passing a lot of urine (you may need to get up often during the night) Feeling very tired Treatment for high blood glucose levels Try to work out why your glucose level is high. If it is Continue reading >>

Ketone Bodies (urine)

Ketone Bodies (urine)

Does this test have other names? Ketone test, urine ketones What is this test? This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces substances called ketones. The ketones end up in your blood and urine. It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. Why do I need this test? You may need this test if you have a high level of blood sugar. People with high levels of blood sugar often have high ketone levels. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels. People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders. Checking your ketones is especially important if you have diabetes and: Your blood sugar goes above 300 mg/dL You abuse alcohol You have diarrhea You stop eating carbohydrates like rice and bread You're pregnant You've been fasting You've been vomiting You have an infection Your healthcare provider may order this test, or have you test yourself, if you: Urinate frequently Are often quite thirsty or tired Have muscle aches Have shortness of breath or trouble breathing Have nausea or vomiting Are confused Have a fruity smell to your breath What other tests might I have along with this test? Your healthcare provider may also check for ketones in your blood if you have high levels of ketones in your urine Continue reading >>

Five Things To Know About Ketones

Five Things To Know About Ketones

If you live with diabetes, you have probably heard that ketones are something to watch out for. That they have something to do with the dreaded diabetic ketoacidosis (DKA). But do you really understand what ketones are and why they happen? It’s scary to think about, sure. But it’s also very important to be in the know about ketones and to be prepared. 1) What are ketones? If there isn’t enough insulin in your system, you can’t turn glucose into energy. So your body starts breaking down body fat. Ketones are a chemical by-product of this process. This can occur when people with type 1 diabetes don’t take insulin for long periods of time, when insulin pumps fail to deliver insulin and the wearer does not monitor blood glucose, or during serious illness (in type 1 or type 2) when insulin doses are missed or not increased appropriately for the stress of illness. Ketones can happen to anyone with diabetes, but the condition is more common in people with type 1. 2) Why are ketones dangerous? Ketones upset the chemical balance of your blood and, if left untreated, can poison the body. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Eventually they build up in the blood. The presence of ketones could be a sign that you are experiencing, or will soon develop, diabetic ketoacidosis (DKA)—a life-threatening medical emergency. 3) When should I test for ketones, and how? There are several situations in which it is a good idea to check for ketones, usually every four to six hours. Talk to your doctor to know what makes the most sense for you and your diabetes management plan. Your blood glucose is more than 300 mg/dl (or a level recommended by your doctor) You feel nauseated, are vomiting or have abdominal pain You are 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 >>

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