How to control ketons?!
Question: How to control ketons!?
i am dietetic and i am spilling ketons how do i control itWww@Answer-Health@Com
Answers:
Ketones are formed when your body's fat stores have to be accessed for energy!. Normally, you eat food and then the body converts it to glucose/blood sugar for use as energy by your cells!. Your insulin is then like a key, unlocking the door to the cell so it can access this blood sugar!. In pregnancy, placental hormones make you more resistant to your own insulin (in essence 'warping' the key to the door) and make it harder to get that glucose from your blood into your cells!. So while your blood remains high in blood sugar, your cells can be starving!. The fetus absolutely must have energy, so if your pancreas cannot make enough insulin to overcome the hormone-caused resistance, the cells start accessing other sources of energy, like fat stores!. The by-product of this is ketones!.
Ketones may be dangerous when pregnant, although this is controversial and still being studied and disputed!. There were several studies that showed that babies exposed to a lot of ketones had learning problems and reduced IQ later in life!. These have since been disputed by other studies, but just in case, everyone plays it safe during pregnancy, which is very prudent!.
What Causes Ketones!?
Ketones usually occur because you are either:
1!. not eating enough total calories
2!. going too long between meals
3!. skipping meals/snacks
4!. nauseous, not eating well/throwing up, and so not getting enough food for energy
5!. so insulin-resistant from hormones that your body cannot access the blood sugar that's there
Your doctor should have you monitoring your first morning urine for ketones daily!. Because of the long overnight fast, blood sugar can drop too low in the night, and the body would have to turn to other sources of energy like the fat stores, thus giving off or 'spilling' ketones!. Your morning blood glucose numbers on your glucometer would not reflect ketones, nor would your bG numbers necessarily be low, since energy had been obtained from other sources!. It is possible for your bG numbers to be normal or even high and yet to also be spilling ketones!.
Not all providers who deal with gd even monitor ketones or place much emphasis on them!. Some are not convinced that ketones pose a potential health threat to the fetus!. And yet, some providers place great emphasis on ketones, while still others try to avoid them but do not give much attention to the issue one way or the other!. It's hard to know how important the issue really is!.
It should be pointed out that his reasoning does not exonerate ketones from blame, just casts doubts---still an important point!. On the other hand, most major authorities remain concerned about the influence of ketone levels and advocate avoiding them!. The diabetic food plans are designed with frequent small meals spaced carefully throughout the day in an effort to keep blood glucose (bG) even and to prevent ketones from developing, just in case they are harmful after all!. The American Dietetic Association's journal, in its 1995 article reviewing nutrition management in women with gd, notes that:
The issue of ketones is particularly pertinent to large women since ketones can be brought on by the use of low-calorie food plans, often prescribed to obese gestational diabetics and even obese women without gd !. This common practice of giving hypocaloric diets without extremely careful attention to ketone testing should be questioned, and the even the practice of giving obese women just enough calories to keep them just above the level of ketonuria should be questioned, since very little has been done to establish the long-term safety of near-ketonuria levels!. This is an area greatly neglected in the research on hypocaloric diets for obese pregnant women!. Although hypocaloric plans offer apparent benefits in some cases, the safety of this approach has not been established adequately, and a number of sources urge caution in their use!.
For example, the American College of Obstetricians and Gynecologists (ACOG) says that "while maternal weight gain and fetal macrosomia may be decreased, the safety of this approach has not been established, and thus it is not recommended" (ACOG Bulletin #200, 1994)!. A number of other sources also recommend caution in approaching hypocaloric diets for obese women, including Gunderson in her 1997 article in Diabetes Care ("caloric restriction during pregnancy even in obese women must be viewed with caution, since its effects may pose some risk to the fetus") and Hachey in his 1994 article in American Journal of Clinical Nutrition ("more caution is necessary in using fat- and energy-modified diets to treat women with gestational diabetes mellitus")!. In addition, the 1995 Journal of the American Dietetic Association article quoted above also notes that "Risk of high levels of blood ketones and risk of sacrificing maternal nutritional status are higher in women who consume hypocaloric diets!." Far more attention to this in the research is necessary and has largely been ignored thus far, so hypocaloric diets for obese gestational diabetics must be treated with great caution and reserve!.
Ketones can also be present even when caloric intake is adequate, especially if intake is sporadic or there are large gaps in time between meals!. Large swings in blood sugar may also exacerbate the ketone problem, and newly diagnosed gestational diabetics often find that they have some levels of ketones present!. As long as these ketones are mild and are tested for and resolved, they are probably not a huge health drain unless large levels are present and are unable to be resolved!. Some studies have found that many normoglycemic pregnant women experience some levels of ketonuria at some points in pregnancy, though probably not as strong as in women with gd!. Kmom is not a medical expert on ketones, but her reading indicates that the consensus seems to be that small amounts on occasion are probably not a serious problem but should be avoided if possible; larger amounts or consistent amounts are more of a worry!. Just how much and how often constitute a concern is a matter of debate!.
In summary, although ketones have not been conclusively proven to be dangerous, neither have they proven to be benign, and there is a fair amount of data linking significant amounts to problems in the baby!. It seems safest at this time to err on the side of safety and carefully test for and avoid ketones!. It is Kmom's opinion that any provider who does not place a high priority on this should be questioned strongly!.
Ketone Tests vs!. Other Urine Tests
It is important not to confuse ketone urine testing for the old urine blood sugar tests!. These are different tests!. In the old days before the current set of blood sugar tests, women were tested for 'gd' by using urine sugar tests!. Only if a woman was spilling significant amounts of sugar in her urine was she tested further to see if diabetes was a problem!. These tests were not sensitive enough to detect most cases of what we call gd today, so if your mother was 'tested' for gd in the old days by this method, you cannot definitely say that she did not have it back then!.
To make the subject of urine testing even more complicated, diabetics used to be able to test their blood sugar levels only through the use of color-coded strips they dipped in their urine!. Exact readings were impossible; the color coding only told diabetics in what range their bG was!. A certain color told them they were low, another told them they were just right, another told them they were a little high, another that they were even higher, etc!. Nowadays, the advent of self blood-glucose monitors (SBGM) has revolutionized blood sugar control!. Now, instead of only getting a vague picture of what their blood sugar is doing, diabetics can get pinpoint accuracy, making tighter control far more possible and thus helping to reduce side effects greatly!. In particular, SBGMs have helped pregnant diabetics greatly improve their pregnancy outcomes, since bG control during pregnancy is so much tighter than when not pregnant!. SBGMs have been nothing short of a miracle for diabetics and gestational diabetics!. Studies show improved outcome with their consistent use by patients at home!.
In spite of this, your urine is still tested for sugar with the old strips at each prenatal visit to be sure you are not spilling a lot of sugar, which could indicate the need for more sensitive blood glucose screenings or new treatment!. However, it is not unusual for some sugar to be present in urine on various occasions (even in women without gd), or for women with gd not to have excessive sugar in their urine either!. So the urine test for sugar, while routine, is not considered definitive for diagnosing gd problems!. Your urine is also tested at prenatal appointments for the presence of protein (which could indicate problems with pre-eclampsia) and white blood cells (which could indicated the presence of a bladder infection)!. These are all various types of urine testing done on pregnant women!.
However, ketone testing is different!. These other urine tests have NOTHING to do with ketone testing, and it's important to distinguish between them!. Some patients and even some providers get confused between tests, especially the old urine sugar tests and the ketone tests!. [One of Kmom's doctors did!.] A few providers occasionally do not have their patients test for ketones; sometimes this is because they are not convinced that it is important, but sometimes it is because even they are confusing the other urine tests with ketone testing!. Ketone testing is considered by most providers to be a vitally important part of monitoring during gd!. If your provider does not have you regularly testing your ketones, you may want to question them further about why, or even consider switching to a new proviWww@Answer-Health@Com
Ketones may be dangerous when pregnant, although this is controversial and still being studied and disputed!. There were several studies that showed that babies exposed to a lot of ketones had learning problems and reduced IQ later in life!. These have since been disputed by other studies, but just in case, everyone plays it safe during pregnancy, which is very prudent!.
What Causes Ketones!?
Ketones usually occur because you are either:
1!. not eating enough total calories
2!. going too long between meals
3!. skipping meals/snacks
4!. nauseous, not eating well/throwing up, and so not getting enough food for energy
5!. so insulin-resistant from hormones that your body cannot access the blood sugar that's there
Your doctor should have you monitoring your first morning urine for ketones daily!. Because of the long overnight fast, blood sugar can drop too low in the night, and the body would have to turn to other sources of energy like the fat stores, thus giving off or 'spilling' ketones!. Your morning blood glucose numbers on your glucometer would not reflect ketones, nor would your bG numbers necessarily be low, since energy had been obtained from other sources!. It is possible for your bG numbers to be normal or even high and yet to also be spilling ketones!.
Not all providers who deal with gd even monitor ketones or place much emphasis on them!. Some are not convinced that ketones pose a potential health threat to the fetus!. And yet, some providers place great emphasis on ketones, while still others try to avoid them but do not give much attention to the issue one way or the other!. It's hard to know how important the issue really is!.
It should be pointed out that his reasoning does not exonerate ketones from blame, just casts doubts---still an important point!. On the other hand, most major authorities remain concerned about the influence of ketone levels and advocate avoiding them!. The diabetic food plans are designed with frequent small meals spaced carefully throughout the day in an effort to keep blood glucose (bG) even and to prevent ketones from developing, just in case they are harmful after all!. The American Dietetic Association's journal, in its 1995 article reviewing nutrition management in women with gd, notes that:
The issue of ketones is particularly pertinent to large women since ketones can be brought on by the use of low-calorie food plans, often prescribed to obese gestational diabetics and even obese women without gd !. This common practice of giving hypocaloric diets without extremely careful attention to ketone testing should be questioned, and the even the practice of giving obese women just enough calories to keep them just above the level of ketonuria should be questioned, since very little has been done to establish the long-term safety of near-ketonuria levels!. This is an area greatly neglected in the research on hypocaloric diets for obese pregnant women!. Although hypocaloric plans offer apparent benefits in some cases, the safety of this approach has not been established adequately, and a number of sources urge caution in their use!.
For example, the American College of Obstetricians and Gynecologists (ACOG) says that "while maternal weight gain and fetal macrosomia may be decreased, the safety of this approach has not been established, and thus it is not recommended" (ACOG Bulletin #200, 1994)!. A number of other sources also recommend caution in approaching hypocaloric diets for obese women, including Gunderson in her 1997 article in Diabetes Care ("caloric restriction during pregnancy even in obese women must be viewed with caution, since its effects may pose some risk to the fetus") and Hachey in his 1994 article in American Journal of Clinical Nutrition ("more caution is necessary in using fat- and energy-modified diets to treat women with gestational diabetes mellitus")!. In addition, the 1995 Journal of the American Dietetic Association article quoted above also notes that "Risk of high levels of blood ketones and risk of sacrificing maternal nutritional status are higher in women who consume hypocaloric diets!." Far more attention to this in the research is necessary and has largely been ignored thus far, so hypocaloric diets for obese gestational diabetics must be treated with great caution and reserve!.
Ketones can also be present even when caloric intake is adequate, especially if intake is sporadic or there are large gaps in time between meals!. Large swings in blood sugar may also exacerbate the ketone problem, and newly diagnosed gestational diabetics often find that they have some levels of ketones present!. As long as these ketones are mild and are tested for and resolved, they are probably not a huge health drain unless large levels are present and are unable to be resolved!. Some studies have found that many normoglycemic pregnant women experience some levels of ketonuria at some points in pregnancy, though probably not as strong as in women with gd!. Kmom is not a medical expert on ketones, but her reading indicates that the consensus seems to be that small amounts on occasion are probably not a serious problem but should be avoided if possible; larger amounts or consistent amounts are more of a worry!. Just how much and how often constitute a concern is a matter of debate!.
In summary, although ketones have not been conclusively proven to be dangerous, neither have they proven to be benign, and there is a fair amount of data linking significant amounts to problems in the baby!. It seems safest at this time to err on the side of safety and carefully test for and avoid ketones!. It is Kmom's opinion that any provider who does not place a high priority on this should be questioned strongly!.
Ketone Tests vs!. Other Urine Tests
It is important not to confuse ketone urine testing for the old urine blood sugar tests!. These are different tests!. In the old days before the current set of blood sugar tests, women were tested for 'gd' by using urine sugar tests!. Only if a woman was spilling significant amounts of sugar in her urine was she tested further to see if diabetes was a problem!. These tests were not sensitive enough to detect most cases of what we call gd today, so if your mother was 'tested' for gd in the old days by this method, you cannot definitely say that she did not have it back then!.
To make the subject of urine testing even more complicated, diabetics used to be able to test their blood sugar levels only through the use of color-coded strips they dipped in their urine!. Exact readings were impossible; the color coding only told diabetics in what range their bG was!. A certain color told them they were low, another told them they were just right, another told them they were a little high, another that they were even higher, etc!. Nowadays, the advent of self blood-glucose monitors (SBGM) has revolutionized blood sugar control!. Now, instead of only getting a vague picture of what their blood sugar is doing, diabetics can get pinpoint accuracy, making tighter control far more possible and thus helping to reduce side effects greatly!. In particular, SBGMs have helped pregnant diabetics greatly improve their pregnancy outcomes, since bG control during pregnancy is so much tighter than when not pregnant!. SBGMs have been nothing short of a miracle for diabetics and gestational diabetics!. Studies show improved outcome with their consistent use by patients at home!.
In spite of this, your urine is still tested for sugar with the old strips at each prenatal visit to be sure you are not spilling a lot of sugar, which could indicate the need for more sensitive blood glucose screenings or new treatment!. However, it is not unusual for some sugar to be present in urine on various occasions (even in women without gd), or for women with gd not to have excessive sugar in their urine either!. So the urine test for sugar, while routine, is not considered definitive for diagnosing gd problems!. Your urine is also tested at prenatal appointments for the presence of protein (which could indicate problems with pre-eclampsia) and white blood cells (which could indicated the presence of a bladder infection)!. These are all various types of urine testing done on pregnant women!.
However, ketone testing is different!. These other urine tests have NOTHING to do with ketone testing, and it's important to distinguish between them!. Some patients and even some providers get confused between tests, especially the old urine sugar tests and the ketone tests!. [One of Kmom's doctors did!.] A few providers occasionally do not have their patients test for ketones; sometimes this is because they are not convinced that it is important, but sometimes it is because even they are confusing the other urine tests with ketone testing!. Ketone testing is considered by most providers to be a vitally important part of monitoring during gd!. If your provider does not have you regularly testing your ketones, you may want to question them further about why, or even consider switching to a new proviWww@Answer-Health@Com
ketons are what you get when you body starts using fat instead of glucose as its primary source due to insufficient insulin (not enough to facilitate glucose into the cells!. If your are a Type 1 diabetic, take your insulin and if you are Type 2 diabetic take your prescribed medicine!.Www@Answer-Health@Com
Drink lots of water to flush them out of your system!. Also, you probably need more insulin!. If your blood sugar is high, take insulin to bring it down!. Ketones usually go with high blood sugar!.Www@Answer-Health@Com
Ketones are a by-product of the breakdown of fatty acids in the blood and urine!. If you have too many ketones in your blood they will "spill over" into the urine!. This can be very dangerous!.
Watch your diet and blood glucose, stay hydrated, and take your meds or insulin!
Keep your eye on your blood sugar because if you're not well controlled, you could have serious side effects!. Talk to your doctor about your blood glucose and ketone control!
Good luck!Www@Answer-Health@Com
Watch your diet and blood glucose, stay hydrated, and take your meds or insulin!
Keep your eye on your blood sugar because if you're not well controlled, you could have serious side effects!. Talk to your doctor about your blood glucose and ketone control!
Good luck!Www@Answer-Health@Com
people with high blood sugars and ketones detected in their urine can go in diabetic coma!.
so please do not take ketones lightly!.
consult your doctor at the earliest!.
meanwhile continue your medicines and drink plenty of water!.
medicines will help to keep blood sugars in control and water will help to flush out the ketones from your system!.
electrolytes that is the level of sodium potassium also vary a lot !.
so please consult your doctor!.Www@Answer-Health@Com
so please do not take ketones lightly!.
consult your doctor at the earliest!.
meanwhile continue your medicines and drink plenty of water!.
medicines will help to keep blood sugars in control and water will help to flush out the ketones from your system!.
electrolytes that is the level of sodium potassium also vary a lot !.
so please consult your doctor!.Www@Answer-Health@Com
You should absolutely be tested for ketones if your blood sugar is higher than 250 mg/dl, if you become ill, or if you are vomiting or experience diarrhea!. Depression and stress are also an indication that ketone testing should be done, and diabetic women who become pregnant should also be tested regularly!. Ketone testing can be done in your doctor's office or in your home with over-the-counter test strips!. When testing at home, if your ketone test is positive, you should contact your doctor right away!. If you have ketones in your bloodstream, that means your body has no glucose to burn, so it starts burning your fat and leaves ketones!.
Again, ketoacidosis is life-threatening, and if you suspect that you have it, you should contact your doctor immediately for treatment!. You should also be tested for ketones!. Your doctor will determine when you should be tested!. Testing is very easy, and is done with urine strips!. You should not eat or drink anything approximately eight hours before ketone testing!.Www@Answer-Health@Com
Again, ketoacidosis is life-threatening, and if you suspect that you have it, you should contact your doctor immediately for treatment!. You should also be tested for ketones!. Your doctor will determine when you should be tested!. Testing is very easy, and is done with urine strips!. You should not eat or drink anything approximately eight hours before ketone testing!.Www@Answer-Health@Com
Getting your blood sugar under control will solve the problem!.Www@Answer-Health@Com
You need help from a professional!. If you are not keeping you diabetes under control,or you are unwell, you need to see a doctor or at least contact a diabetes clinic for advise!. It can be very dangerous not to!.So ring one NOWWww@Answer-Health@Com
Keep your sugar level down to a safe levelWww@Answer-Health@Com
Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis!. DKA occurs mostly in type 1 diabetes!. It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death!. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia!. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia!. (Merck)
In diabetic patients, ketoacidosis is usually accompanied by insulin deficiency, hyperglycemia, and dehydration!. Since insulin is required to absorb glucose from the blood, its deficiency results in an energy crisis, fatty acid metabolism, and production of ketone bodies!. Hyperglycemia results in glucose overloading the nephron and spilling into the urine!. Dehydration results following the osmotic movement of water into urine, exacerbating the acidosis!. (Wikipedia)
The goal of treatment is to correct the elevated blood glucose level by giving additional insulin, and to replace fluids lost through excessive urination and vomiting!. A person with diabetes may be able to recognize the early warning signs and make appropriate corrections at home, before the condition progresses!.
If ketoacidosis is severe, hospitalization is required to control the condition!. Insulin replacement will be given, fluid and electrolytes will be replaced, and the cause of the condition (such as infection) will be identified and treated!.
(MedlinePlus)
There's much you can do to prevent diabetic ketoacidosis and other diabetes complications!.
* Make a commitment to managing your diabetes!. Make healthy eating and physical activity part of your daily routine!. Take oral diabetes medications or insulin as directed!.
* Monitor your blood sugar level!. You may need to check and record your blood sugar level at least several times a day
In diabetic patients, ketoacidosis is usually accompanied by insulin deficiency, hyperglycemia, and dehydration!. Since insulin is required to absorb glucose from the blood, its deficiency results in an energy crisis, fatty acid metabolism, and production of ketone bodies!. Hyperglycemia results in glucose overloading the nephron and spilling into the urine!. Dehydration results following the osmotic movement of water into urine, exacerbating the acidosis!. (Wikipedia)
The goal of treatment is to correct the elevated blood glucose level by giving additional insulin, and to replace fluids lost through excessive urination and vomiting!. A person with diabetes may be able to recognize the early warning signs and make appropriate corrections at home, before the condition progresses!.
If ketoacidosis is severe, hospitalization is required to control the condition!. Insulin replacement will be given, fluid and electrolytes will be replaced, and the cause of the condition (such as infection) will be identified and treated!.
(MedlinePlus)
There's much you can do to prevent diabetic ketoacidosis and other diabetes complications!.
* Make a commitment to managing your diabetes!. Make healthy eating and physical activity part of your daily routine!. Take oral diabetes medications or insulin as directed!.
* Monitor your blood sugar level!. You may need to check and record your blood sugar level at least several times a day
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