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RE: [IPk] overnight ketones & dodgy A1c



Elizabeth

I don't test for ketones (unless over 16 for any length of
time) but when I was pregnant they tested every time for
ketones and I remember being surprised that I produced
ketones with a BGM of 10.  I was told that the ketone
threshold varied from person to person but that starting to
produce ketones at a BGM of 10 was not unusual.

I aim for less than 7 at night which gives me a little more
leeway during the day (said she who has just eaten a
(pre-bolused) packet of wine gums!).

Bev



_______________________________________
Beverley Smith
Principal Development Geologist
SNS Team Leader

Phone: 0118  929 2422
Fax: 0118 929 2660
E-mail: email @ redacted


> -----Original Message-----
> From: Elizabeth OShea [mailto:email @ redacted]
> Sent: 16 April 2002 15:03
> To: email @ redacted
> Subject: [IPk] overnight ketones & dodgy A1c
> 
> 
> HI all -
> 
> I'm a woman in need of advice. I'm trying to sort out my 
> overnight basals 
> (yes, yes, 3am test). I have been doing overnight testing 
> (one night I did 
> 12am, 1am, 2am, slept through the 3am alarm, and 5am). I've

> been doing this 
> for over a week at this stage, and I've never caught
anything 
> hugely out of 
> range - the readings are anywhere between 4 and 10, but not
higher.
> 
> However, I also have ketones every night. For example, last

> night at 9pm I 
> was at 10.2, I had an adjustment bolus and insulin for an 
> eggs-and-cheese 
> dish. At 1.25am I was at 7.7 and I had a trace of ketones.
At 
> 6.57am I was 
> at 9.4 and I had small ketones. These numbers are a bit
high 
> compared to 
> other days, but the ketone pattern is the same.
> 
> None of my overnight testing has demonstrated particularly 
> high or low BGs 
> over a period of hours.
> 
> My head (often a good indicator of what has happened 
> overnight) feels fairly 
> fine in the morning. Not particularly muzzy or achy. I'm
also 
> not thirsty 
> when I wake up in the morning, which I would expect to be
if 
> I'm producing 
> ketones.
> 
> Question: What would cause me to produce ketones at BGs 
> between 3-12? This 
> is the range I've seen over the past week, on different
days.
> 
> To add to my frustration, I got A1c results back today: 7,
up 
> from 6.8 four 
> months ago, which was up from 6.2. Last time the nurse has 
> told me the very 
> poor BGs I had over christmas week probably caused that
large 
> increase, but 
> clearly that is not the case because I have been doing well

> in terms of 
> recorded numbers for the past 6 weeks or so. I had an A1c
of 
> 6 for a year 
> after starting the pump, so as you can imagine I am very 
> concerned about all 
> this. Clearly, I have a problem overnight.
> 
> So, I'm doing overnight tests, tracking results, and
changing 
> basal rates 
> when appropriate. Any other suggestions? Oh yes - I will be
making an 
> appointment with my diabetes day centre, but I'd like an 
> expert opinion as 
> well.
> 
> elizabeth
> 
>
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