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[IP] basal insulin and ketones
Barb and Duck wrote:
> So, Natalie, clarify........
> * Basal insulin - no ketones with high sugars?
Yes, BUT this is a tricky one, because with a child, the basal needs
change frequently, so you might have a situation where you THINK the
basal is sufficient, but it's not. In addition, basal needs can change
depending on what time of month it is, and I don't know if Erica is
cycling or not, but the cycles start to show up BEFORE the periods do.
Plus exercise alters basal needs -- a couple of days of high activity
may result in a low basal need, whereas couch potatoism can raise basal
> * No basal insulin - ketones would show up, even if the sugar were
> not in a really high range that you would normally check for
Yes, again. There is a phenomenon called starvation ketosis that occurs
in normal people who are literally starving to death. The liver has
exhausted its glycogen supplies, and the BG is in normal or mildly low
range, so the pancreas stops secreting insulin and the body starts to
tear down its own tissue for energy resulting in ketones.
People on extreme low-carb weight-loss diets are encouraged to test for
ketones, because they show that the body is tearing down fat and muscle,
therefore losing weight, but the BGs are normal. (Why this would be a
good method for weight loss is beyond me!)
In Type 1 diabetics, as soon as there is no insulin available, the body
immediately starts to tear down fat and muscle and produce ketones.
HOWEVER they may not show up in the urine for a while because they need
to go over a certain level before they spill.
The situation for a diabetic is usually that with a lack of insulin, the
liver DOES begin to convert glycogen to glucose (as opposed to
starvation, where there is no glycogen to be had), so high BGs will
usually accompany ketones.
In the olden days before insulin, treatment was to keep the BGs down by
feeding the kids a VERY low-carbohydrate diet -- it worked as far as the
BGs were concerned, BUT didn't stop ketosis and emaciation, and
eventually DKA from killing the child. A full-blown Type 1 can die of
DKA with BGs in the 200's whereas a Type 2 can run in the 500's with
nary an immediate problem! (But wait till later when the complications
I hope this is a clarification -- feel free to discuss!
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Natalie A. Sera, with all her ducks in a row!
Type Weird, pumping!
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