Type 1 diabetes and Ketones

[Apointu1]

I am 18 years old and have just finished my last A-level exam today! Over the last 2 weeks my ketone levels have varied; sometimes they are 0 and they have gone up to 8mml. With this rise in ketone levels my glucose sugar control went crazy and I have been taking almost double the amount of insulin and still been running on highs above 20. I have been to the hospital twice (which clarified I had ketones in my blood and urine and also that I had a large amount of glucose in my urine too) and on the phone to NHS Direct to try and solve the problem as it was interfering with my revision and exams by all they have done is given me information such as drink lots of water and take extra insulin but two weeks later I haven't seen a change and my ketone levels are still unpredictable.
I don't know what to do because I've finished school and will have a lot of time in my house alone so I want to get the problem sorted in case their is an emergency.

[Lisa Holmes]

Well dine on finishing your exams! Are you now in adult care or are you still under Paediatrics? If you can contact the consultant ( or their secretary) I would see if you can get an appointment or at least speak to them on the phone just so they can give you some advice and help you plan how to deal with this. Now that the exams are over then your blood sugars should gradually return to normal, but I would suggest you do regular blood testing to check your levels as if you have been having a lot of insulin for a couple of weeks and your exams have now finished then you won't be having the stress response and so have more stable blood sugars but still having large insulin doses and your blood glucose could drop suddenly.

[Dr Masud Haq]

Well done on completing your exams.

I think it's essential you contact your GP or Diabetes specialist as soon as possible. The presence of ketones usually implies your body is short of insulin leading to break down of your fat stores and subsequent build up of ketones.

When blood ketones are checked they are usually graded in 3 ways.
0.1 - 1.0 mmol/l is classed as acceptable.
1.1 - 3.0 mmol/l is high and additional quick acting insulin is required
anything above 3.0 mmol/l there is a risk of ketoacidosis.

I'm not too sure whether you have any signs of an infection but this is often the cause of elevated blood glucose levels and raised ketone levels. I would recommend you test your capillary glucose levels more frequently as well as blood ketones. If you still have raised blood ketones I would recommend drinking more water to keep yourself hydrated. It's important you continue to take your insulin but you will need to take additional regular amounts of quick acting insulin to bring your capillary glucose levels under control. Once this is acheived your blood ketones should clear. If this fails to happen you are at risk of developing diabetic ketoacidosis. Hopefully you can avoid this with taking appropriate measures but ask for advice from your diabetes specialist.

Hope you feel better soon.
Masud