# Starvation Ketones and Diabetes Ketones.



## sasha1 (Aug 10, 2009)

Hi All...

In one or my replies yesterday I mentioned the 2 type of ketones...Thought it might be useful to some to explain the difference.


STARVATION KETONES:    Starvation Ketones are produced when the  BG level is low. The urine glucose concentration will then be low too. The reason the cells are starving is because there is not enough food and glucose in the blood, which happens when you have'nt been eating enough, when you have been vomiting, or if you have gastroenteritis. If the low BG is caused by a high dose of insulin, the production of ketones will be stopped as insulin counteracts the transformation of fat and fatty acids to ketones.


DIABETES KETONES:     If you are deficient in insulin, the available glucose will be in the wrong place, i.e. in the bloodstream outside the cell instead of inside the cell. Both the glucose level and the urine concentration will then be high. High BG level at the same time as ketones and high urine glucose concentration (3-5%) always suggests a shortage of insulin, as long as the urine test is taken during the day and you have not suffered from hypoglycaemia recently.


KETONES IN THE MORNING URINE:    When you wake up in the morning, urine has been in the bladder for so long that it is very difficult to say exactly when during the night the glucose or ketones entered the urine. A urine test might show both glucose and ketones if you had a hypo early in the night, followed by a rebound effect in the morning with high BG resulting in both glucose and ketones in the urine. The same results will be seen if your BG has been high all night and the cells have been starved of sugar by a shortage of insulin. In this case, the ketones may make you feel sick in the morning. Ketones without glucose in the urine indicate you may not have eaten enough before going to bed.


HIGH LEVELS OF KETONES:    If you are insulin-deficient, you will feel unwell. This is caused by the increased level of ketones, rather than the high BG level. If your body is producing lots of ketones, your body will become acidic. Passing ketones into the urine is the bodies way of getting rid of the excess ketones.

Heidi
xx


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## Steff (Aug 10, 2009)

thank you heidi you always do such informative posts , i didnt even realise they was 4 diffirent kinds 

cheers xx


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## insulinaddict09 (Aug 10, 2009)

Thanks Heidi , you beat me to it !!! I was reading some posts this morning and someone ( a type1 for several yrs) was confused over Ketones and the different ones , especially starvation ketones and ketones for dka .


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## Lizzie (Aug 11, 2009)

Hi

I am confused. So if a type 1 was to get ketones due to starvation, would that show up on the ketostix? And would that then cause DKA? Are the different ketones different chemically or are they the same, just caused by different things? What I mean is, for a type 1 does it all add up to the same thing really, if you have ketones you drink water and take more insulin as advised by the doctor regardless if they are starvation, morning or diabetic ketones? Or should different ketones be treated differently? I have never been told about different ketones.


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## Northerner (Aug 11, 2009)

Lizzie said:


> Hi
> 
> I am confused. So if a type 1 was to get ketones due to starvation, would that show up on the ketostix? And would that then cause DKA? Are the different ketones different chemically or are they the same, just caused by different things? What I mean is, for a type 1 does it all add up to the same thing really, if you have ketones you drink water and take more insulin as advised by the doctor regardless if they are starvation, morning or diabetic ketones? Or should different ketones be treated differently? I have never been told about different ketones.



Hi Lizzie, it's when you have ketones (of whatever variety - they are the same chemically) in conjunction with high BG levels that you're at risk of DKA. If your BG levels are OK then it means you have sufficient insulin circulating to process the ketones, and they are 'starvation' ketones produced from fat metabolisation because there is insufficient carbohydrate in the system.


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## Caroline (Aug 11, 2009)

Thanks Heidi, I still have a lot to learn. At least I can get good information here.


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## Lizzie (Aug 11, 2009)

Northerner said:


> Hi Lizzie, it's when you have ketones (of whatever variety - they are the same chemically) in conjunction with high BG levels that you're at risk of DKA. If your BG levels are OK then it means you have sufficient insulin circulating to process the ketones, and they are 'starvation' ketones produced from fat metabolisation because there is insufficient carbohydrate in the system.



Thanks Northerner. So how high do you have to be to know they aren't starvation ketones?


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## Northerner (Aug 11, 2009)

Lizzie said:


> Thanks Northerner. So how high do you have to be to know they aren't starvation ketones?



There seems to be slightly differing advice given to people, but it is usually if BG is in the high teens (16-18) with ketones present, and if the high levels persist despite correction doses being given. This usually means that the person has an illness or infection brewing if insulin requirements are suddenly raised. Ketones are generally less of a problem for Type2s not on insulin, as their own pancreas will try to produce more in response to the higher BG levels, so they are less likely to get DKA.


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## insulinaddict09 (Aug 11, 2009)

Lizzie said:


> Thanks Northerner. So how high do you have to be to know they aren't starvation ketones?



As a Low Carber ( very low carb) I am quite often in Ketosis , as I have ample Insulin in my body It is not a problem as Ketosis is a normal body function , It is the bodies way of using stored body fat as energy etc. Ketones only become a problem if you do not have enough Insulin in your body to "keep them in order" and stop a mass production which then leads to acidic blood and Diabetic Ketoacidosis.


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## katie (Aug 11, 2009)

AM do you usually just get 'traces' of ketones?  As I just checked again today and ive got 'moderate' ketones again :/


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## insulinaddict09 (Aug 11, 2009)

katie said:


> AM do you usually just get 'traces' of ketones?  As I just checked again today and ive got 'moderate' ketones again :/



Yes I do , if you have enough Insulin in your system it isnt a problem to have ketones as its the bodies natural way of burning fat for energy. If you have high sugars and ketones for any length of time it becomes a problem as you are at risk of DKA. You will be showing up Ketones as you are burning fat and not Carbs for energy. burn fat= weight loss


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## katie (Aug 11, 2009)

ok.  umm I only have one test strip left (lol again) so im saving it for a special occasion until tomorrow.  I *shouldnt* be high, but going on the last few days I could easily be.  I'll take a bit extra insulin at dinner and test again later   Don't worry, getting my script tomorrow!


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## insulinaddict09 (Aug 11, 2009)

katie said:


> ok.  umm I only have one test strip left (lol again) so im saving it for a special occasion until tomorrow.  I *shouldnt* be high, but going on the last few days I could easily be.  I'll take a bit extra insulin at dinner and test again later   Don't worry, getting my script tomorrow!



Tut tut , Hmm yes I need to sort out my script too lol


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## katie (Aug 11, 2009)

Hehe i did mine online earlier!  If I had remembered I can do it online I could have had my script by today, grr!

Ive decided it cant be because im high because I cant have been high for that long... if I am... if that makes sense


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## insulinaddict09 (Aug 11, 2009)

katie said:


> Hehe i did mine online earlier!  If I had remembered I can do it online I could have had my script by today, grr!
> 
> Ive decided it cant be because im high because I cant have been high for that long... if I am... if that makes sense



Hmm as a guess Id say it was just Ketosis , as you are Low Carbing your body wants the glucose so is burning fat to get it , as long as you keep taking your insulin and dont have sugars sky high you will be ok. It doesnt sound like DKA ketones to me , Ive always got ketones now that I Low Carb, its one of those things , but if I felt ill and was sky high Id be thinking DKA and Id be jabbing away with my Insulin lol


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## katie (Aug 11, 2009)

Well I definitely take enough insulin   I took way for insulin than my ratio would say I should have, but I'm def not low.  Urgh, so annoying!


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## insulinaddict09 (Aug 11, 2009)

katie said:


> Well I definitely take enough insulin   I took way for insulin than my ratio would say I should have, but I'm def not low.  Urgh, so annoying!



I think your Basal needs adjusting then , you should do a Basal test and see what happens , I did one and after upping my Levemir 2 units Ive pretty much had good levels all the time ( the odd rogue tho )


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## katie (Aug 11, 2009)

Yeah I think I will try that when I get my new strips tomorrow   Might up it tonight anyway and see how it goes, doubt i'll go low!!


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## sofaraway (Aug 12, 2009)

We are going to have to sort out some system so we can alert and remind you to order test strips Katie! Hope you manage to get them today.

Am typically what blood ketone levels do you run when low carbing?


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## katie (Aug 12, 2009)

sofaraway said:


> We are going to have to sort out some system so we can alert and remind you to order test strips Katie! Hope you manage to get them today.
> 
> Am typically what blood ketone levels do you run when low carbing?



lol I know, i'm so useless! I think it will help if I remember I can order them online now!!


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