School me on ketones please

[nirvana]

Hey all

So, i mostly just would like some clarification on ketones and how they work, i think i know the answer to my question but the last time i really was educated at all on ketones was when i was diagnosed, 8 or so years back

Anyway, so recently i've noticed that my urine has a high level of ketones, even with normal blood sugar ranges, in fact my blood sugar has been better than normal recently due to a change in diet. That change in diet is what i'm thinking might be causing it, i've basically cut out a lot of bread and starchy carbs, i'm trying to lose weight so i've moved to a diet of mostly protein, with just carbs coming from veggies/fruit, and the methods throughout the day of keeping my blood sugar from going low if i'm being active.

So it's my understanding that Ketones are a by product of your body burning fat, which is happening in my case most likely due to my bodys cells needing energy but my diet not providing that energy.

The only thing i'm not understanding is if my blood sugars are around the normal ranges, and my cells are needing this energy, when the fat is burned to create the energy, why aren't my blood sugars skyrocketing, or at least showing some kind of random highs? To me it seems like unless i had insulin in my system to counteract that influx of sugar via the fat being burnt, my bgl would go up, and if i had that insulin in my system i would be going low most likely and needing to intake sugar to fix that, resulting in my body not needing to burn the fat to make the energy as i would have just introduced it via my diet...

And also, the ketone readings aren't moderate or anything, it's been high every time, should the amount be less than it is, especially considering i haven't exactly stopped all carb consumption, as i said i still get it from veggies/fruit, and i still have some carbs throughout the day in the form of soft drink to bring up any slightly low blood sugars if i need to be active, or if i'm preempting being active i will have some dairy milk chocolate which i find releases carbs slowly and works well for me..

And lastly, what are your guys opinions on the ketone urine stick things vs the blood tester ketone strips, would i maybe benefit from one more than the other, or both?

Any helps/opinions would be appreciated

Thanks!

[Catapult]

A while ago (a few years back) for several weeks I was feeling a bit weird and testing my BGLs, all normal to lowish, and tested my urine ketones, all moderate to high. I called my Endo who advised me to inject more insulin and therefore I'd have to eat more carb. I can't remember if I did that or not, but the problem went away. It is my understanding that dieting can lead to small ketones but not large, so perhaps you'd best contact your Endo for advice.

Cat.

[LisaCee]

Just guessing, but I find eating more protein is dehydrating, so if your urine is more concentrated, the ketones might be more concentrated too. If I get ketones, I like to drink a lot of fluids to flush them out and ease the accompanying headache. Fluids help to digest a high protein diet too and reduce constipation. Protein still needs insulin even though it is digested more slowly, so maybe you are getting spikes later on. My DE said I can get ketone readings with a decent BGL because the ketones show up first, usually followed by a high later.

If I am exercising, I can get ketones from not eating enough because I am burning fat. "Normal" people burn fat and get a little bit of ketones, so it makes sense why dieters are grumpy!

I like to use the Optium blood ketone strips because I like a definitive answer, rather than a urine stick where you have to judge a colour. It does take a fair old whack of blood compared to BGL tests, but it's not an everyday sort of thing for me.

[Catapult]

Also plenty of times I have had moderate to large (dark purple) on the urine ketone strips, but tested 0.0 on the Optium blood ketone test.

Cat.

[Magenta76]

Hey Nirvana,
There are so many ways that this topic can go, but I'm going to start with "sick days".
Ok, so when I have a sick day, it usually means that I have traces of ketones present. I have sick day management in place so I follow that. That consists of, me doing BSL tests every 2 hours and usually extra insulin as well. It is still possible to have "normal" BSL's and still have ketones. If that happens with me, I still keep going with the testing and extra insulin, but it means that I just have to have extra carbs to go with the extra insulin.

I am also on a high protein, low carb diet. I limit myself to between 60 to 80g a day. I am purely doing it in order to lose weight. Once I have gotten to my ideal weight, I will up the carbs to between 80 to 100g a day. If you are on lower amounts of carbs, like the Atkins diet, (which is 20g) it is relying on you developing ketones in order for the weight lose to occur rapidly. Which, I think is not only a really bad idea for non diabetics, but an even worse idea for us, as ketoacidosis is not fun and not to mention super dangerous. I would assume that you have spoken with your DE/Endo/dietician in regards to your low carb diet and so therefore I would also assume that that isn't your issue.

The only thing i'm not understanding is if my blood sugars are around the normal ranges, and my cells are needing this energy, when the fat is burned to create the energy, why aren't my blood sugars skyrocketing, or at least showing some kind of random highs? To me it seems like unless i had insulin in my system to counteract that influx of sugar via the fat being burnt, my bgl would go up, and if i had that insulin in my system i would be going low most likely and needing to intake sugar to fix that, resulting in my body not needing to burn the fat to make the energy as i would have just introduced it via my diet...

Then again, maybe it is. I would suggest talking to a dietician to work out what your energy needs are. Perhaps you need to adopt more low GI carbs into your diet in order to avoid the ketones, because, as I said, they're extremely dangerous

As for urine testing strips to blood, I think it really is a personal preference. I do know that the urine strips let you know what was happening 4 hours ago in your blood, and the blood testing strips advise on what was happening within the hour, so for me blood strips are the way to go. (I have had many admissions of DKA so I've done this lots...)

I hope you get it sorted soon

[LuciaL]

Fact sheet: http://www.d1.org.au/images/stories/Doc ... etones.pdf