Ketones from being sick?

[Bobby T]

Ok so I have a cold and my glucose is 210.I have small ketones but my sugars are bellow 240?Do you get them from being sick?because my sugars are not that bad?

[drummingfool]

Yes. ketones are released when you get sick. I've had the flu before and had perfect BG (90-130) and still had ketones. I think they're just part of your body fighting off the sickness.

[DeusXM]

Standard thing when you're ill. Don't worry about them unless they start getting really high and your BG is really bad. You'll have elevated BGs and ketones while you're ill - best thing to do is drink plenty of water and try and keep a lid on the BGs with more insulin.

[GrammaBear]

How do you know when ketones are getting really high? Sorry for what might seem like a dumb question, but when I was diagnosed my doctor told me that Type 2 diabetics don't get ketones. I am insulin dependent and also Type 2. A few weeks ago (I had an ear infection) my BG went into the 'above 200' range which is unusual for me. I tested and found that I had ketones - scared the heck out of me. Where can I learn about ketones and how to handle it when you do?

[dbaratta]

How do you know when ketones are getting really high? Sorry for what might seem like a dumb question, but when I was diagnosed my doctor told me that Type 2 diabetics don't get ketones. I am insulin dependent and also Type 2. A few weeks ago (I had an ear infection) my BG went into the 'above 200' range which is unusual for me. I tested and found that I had ketones - scared the heck out of me. Where can I learn about ketones and how to handle it when you do?

I think they sell dips for that over the counter at the pharmacy don't they? I have never used them but I thought I saw them.

[fgummett]

In very general terms:

Ketones are really only an issue when you have no insulin -- the stereotypical Type 1 D who is truly "insulin dependent".

A Type 2 who is using injected (exogenous) insulin to help control BGs, is likely (but perhaps not always) still producing some insulin of their own but may need extra as a "top up" to overcome insulin Resistance (IR).

Ketones are simply a sign that the body is utilizing fat for energy, but like anything (BG, Oxygen, etc...) high enough levels can become toxic. Eating very low carbs I show Ketones in my urine (test with Ketostix) pretty much every evening.

The potentially deadly consequence of Type 1 D that is uncontrolled with insulin is: toxic levels of both Ketones AND BG -- Diabetic KetoAcidosis (DKA)... the BG keeps going up as there is no insulin to manage it meanwhile the body can only burn fat for energy.

DKA is often confused with Ketosis... the first is very dangerous, the second is normal.

That said, DKA is also possible in uncontrolled Type 1.5, Type 2 and so on. And as we know here on DF, it is not unknown for a misdiagnosis of Type to happen.

[Subby]

Bobby has posted before as a type 1.

I agree with all that up to this point:

DKA is often confused with Ketosis... the first is very dangerous, the second is normal.

For the type 1 diabetic, elevated ketones due to insulin deficiency is not DKA, but it is also not "normal". It is a warning sign of lack of insulin and may be a precursor to DKA.

Also, ketosis (without necessarily reaching DKA) in the amounts that can be easily caused by insulin deficiency in T1, can be very uncomfortable and sickening. Dehydration, feverish sensations, grogginess, would be common reactions to significant ketosis (but again not necessarily DKA). So I think care needs to be taken when defining ketosis, in the T1 context, as "normal" or all that far away from DKA.

[fgummett]

You are right of course... perhaps I was being too general.

Is it reasonable to say that ketones with a normal BG is something to watch but not to be overly concerned about?

Keep well hydrated.

[Subby]

You are right of course... perhaps I was being too general.

Is it reasonable to say that ketones with a normal BG is something to watch but not to be overly concerned about?

Keep well hydrated.

My understanding is that below around 230 mg/dl / 12 mmol/l, ketones are really unlikely to be present from the cause of insulin deficiency, so if you had normal BGs let's say loosely ranging under 144 / 8 mmol/l, I don't think it would be normal to be seeing ketones for that reason at all. Of course, there is low carb and sickness then, to be looking at.

Or, if the blood sugar has been significantly elevated in the past half day, (or longer? not sure on the time period) ketones can take a while to clear the body...