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[IPk] Re: Ketones with non-high bg
In a message dated 4/17/2002 1:13:07 AM GMT Daylight Time, email @ redacted
> 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
> 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
> 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
> 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
Sorry to hear that things haven't been going as well as you'd like.
I agree with other comments made today - do check the meter and strips first,
as your HbA1c has been rising (though personally I'd kill for results like
that, I appreciate that for you it's not so good). If they're OK, then there
are other causes of ketone production - hyperglycaemia isn't the only one,
some are not necessarily abnormal/harmful. You've sent in previous
correspondence that makes me think these others may be relevant if your
equipment's accurate. Factors such as eating a higher fat/protein diet,
veg-based but with low/lowish carb content; lots of exercise without carb
backup; not eating for long periods; being underweight with the previous
factors - can cause ketone production to occur. I agree that it's really
only worth testing if your bg is raised, 14 and above is the figure normally
By the way, I do apologise for problems in my transmissions, half of what I
wrote to Donald yesterday was missed out. Still can't get the hang of
editing with the new system. (Help!!!)
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