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RE: [IPk] Re: ketone testing

It is some years since I was a research chemist but if I remember correctly
the body gains energy via two main pathways. The first, as I guess you know
is by breaking carbohydrates down to carbon dioxide & water involving
insulin. The second is Krebs cycle where fats are broken down to something
that can be easily urinated out of the body such as an acid (via several
steps) or failing that, ketones. Normally it will breakdown carbohydrates.
When you exercise heavily you will burn through the carbohydrates stored in
muscle cells and then breakdown the glycogen stored in the liver to glucose;
when that is finished the body will start on the fat reserves. You will
generate ketones more when lacking oxygen such as when running faster than
your lungs can cope with. I guess that too little insulin will force your
body to top-up its energy needs via Krebs cycle. Too much insulin will cause
your body to raid the stored glucose & glycogen quicker and proceed onto
breaking down fats resulting in more ketones.

I think this is the main jest of it but would like to hear from anyone with
a different picture. What happens when you start eating less and loose fat;
it must mean that you are at risk of generating ketones?, look out!

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted]
Sent: Wednesday, September 27, 2000 11:01 AM
To: email @ redacted
Subject: Re: [IPk] Re: ketone testing

>The one time ketone testing was really useful for me was last winter
when I had flu.  For several days, I drank lots of water and
unsweetened herb tea and clear soups but hardly ate or drank any carbs,
raised the basal rate on the pump, tested frequently and had very
nicely low blood sugars, and couldn't understand why I was feeling
increasingly lousy.  ...  Wished I had known already in the night that the
first thing
to try in case of ketones with relatively low blood sugar was sweet
drinks and lots of insulin - could have avoided a few bad hours, and
making a spectacle of myself in the GP's waiting room.  The other moral
of the story is to test ketones liberally when ill - they can go high
even if you dont have the more obvious warning of high blood sugar.

Ah!  And I remember testing ketones the evening after I did the mini
marathon. The stick came up quite dark, and I got a fright. I was very
puzzled, because my BG was 10 or so, which doesn't warrant ketones - I
don't even remember what possessed me to do a ketone test. I had not pumped
any insulin for an hour during the race, but I had never had no insulin in
my body, because I did eat something after the race, which I covered.  My
diabetes nurse said I had ketones because I hadn't been pumping for that
hour, but I don't think that's quite accurate. Why?  Because since then,
I've been off-pump for over an hour for exercise on a few occassions, and I
haven't subsequently had ketones.  I think it's because in those situations
I did a better match between my food and insulin than I did after the
minimarathon.  But I haven't had the time or inclination to work out the
explanation behind it!  I took the sweet drinks and lots of insulin route
as soon as I finished the exercise.  I chose that option because I was
thirsty, not because of any knowledge!  It seemed to work, anyway. So now
if I'm off my pump for over an hour for exercise, I have 4 units and a
suitable amount of 7Up or something like.  The times I used this I was in
the US, where I got ginger soda, which was yummy! Much nicer than 7Up.


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