So I just performed my first Ketone test with a Keto Mojo. Are these readings good?
Glucose: 54 mg/dl
Ketones: 5.8 mmol/L
The GKI says 0.5 and states You are in the highest therapeutic level of GKI ketosis
Also, my circumstances are unique. I was diagnosed with Type 2 diabetes a few weeks back. Obviously, my blood glucose is very low now. Typically, ketoacidosis is something about which Type 1s must be concerned. I cannot understand if Ketoacidosis is a danger I am in with the levels above. Every where I read about it they’re concerned with high glucose, not low.
First, to put your mind at ease, as a Type 2 diabetic, my understanding is that you have nothing to worry about re: ketoacidosis. And with these figures, all the more so.
If anything, you have low blood sugar and your ketones are in a very healthy (newbie) range. “Newbie” in the sense that high BHB readings are far more common in those who recently cut out the carbs from their diet than in those who have been carb-restricted for longer periods of time.
Whether the readings are “good” is a more challenging question, since everyone is different and everyone changes over time, so it’s a bit treacherous to describe someone’s snapshot one-time data as good or bad.
Having said that, I would guess that you’re off to a solid start in improving your health. The more relevant questions might be…
What are you eating and how is that working out for you?
How do you feel? Energy level? Concentration? Sleeping? Hunger levels?
What are your goals (besides managing and/or reversing your T2D issues)?
Anyhow, congratulations on your having set yourself off in this direction. You’re likely to be on the verge of making a massive change in your health (for the better!)
Glucose is no longer the primary fuel of the body, so high levels aren’t really needed. The liver is producing as much as it needs, via Gluconeogenesis.
Typically, it’s an exhaustion of insulin in the blood that causes DKA. When blood insulin levels are nil, it triggers the liver to produce fuel, and more fuel – both glucose and ketones. That is supposed to raise insulin levels, which tells the liver to stop producing those fuels.
So, a type 1 that has no insulin in the blood, and is producing no insulin, will never have anything to tell the liver to stop. Which usually results in the high ketones AND high glucose.
I wish it were true. I’ve been T2D for 25 years. Keto going on 4 years. Strict Keto, under 10 carbs a day. I’ve never had a blood glucose reading under 100 mg/dl. Even after fasting for 4 days. Is my liver producing the sugar via gluconeogenisis?
Congratulations, you are definitely in ketosis. Those are great numbers.
The glucose number would be low enough to be a problem if you didn’t have any circulating ketones, but at 5.8, you have a goodly amount. When ketones are as high as yours are at the moment, they will keep your brain abundantly fed, despite the relatively low glucose.
In general, it is fair to say hyperglycaemia is always a problem, because it has bad long-term effects, and can even cause problems in the short term if serum glucose rises high enough. The damage from hyperglycaemia is then further compounded by the hyperinsulinaemia that results as a consequence.
Type I diabetes is a condition of no insulin at all, except for whatever is administered therapeutically. Type II diabetes, on the other hand, is a condition of too much insulin, complicated by insulin resistance in key organs, making glucose control difficult.
The most widely used diagnostic criteria for diabetic ketoacidosis are (1) plasma glucose > 250 mg/dL, (2) arterial pH < 7.3, and (3) plasma β-hydroxybutyrate > 10.0 mmol/L. This combination can exist only in the absence of insulin. Your pancreas is producing insulin, so you need have no fear of diabetic ketoacidosis.
And for the sake of completeness I will mention that there is also a condition known as euglycaemic ketoacidosis, which is of concern only if you are taking a type of drug known as an SGLT-2 inhibitor.
Thank you, Sir, for the careful response. Here are the answers to your questions:
I am eating essentially protein (moderate to heavy), veggies & greens (raw spinach salad), and fats (butter, cheeses, avocado). I don’t focus on macros, but I try to balance out the three properly. Essentially, my calorie intake is hard to determine, because I have already gotten into a groove of only being hungry around supper time each evening. I simply am not hungry most of the time, it seems. My meal tonight, for example, was a 1/3lb burger patty with bacon, cheddar & pepper jack cheese, a fried egg, with “cheese crisp” bun. I also ate a side salad with lettuce, cabbage, thinly sliced carrots, shredded cheese, tomatoes, and an avocado. That filled me to the brim. In most cases, I eat more fat than this, but I ate out today.
How do I feel? This is a difficult one, because so many ancillary conditions played a part this week. I jumped all in on keto the 22nd. Not too long before I was essentially on 20-24 hour fasting (naturally, just not hungry). I weight train on Mondays, Wednesdays, and Fridays (with StrongLifts 5x5), and go for walks (10k steps or more) every day. My blood sugars started out in the 90-110 range, when I first began eating well. By the 27th, I started getting the very low readings. I had brain fog, and some trouble sleeping, but none of the other things that accompany hypoglycemia (essentially, I was not nervous, nor shaky, nor weak). I retained all the energy, but had some headaches, and the brain fog, and the difficulty sleeping. As it turns out, a stomach bug was going through a few families from church, and I may have caught that (had some interesting bowel movements), but last night I began feeling much better. I also slept very well last night and felt great today. There is still some brain fog, but no headaches. Yet my blood sugars are still low. I don’t know if the Keto flu is supposed to still be occurring?
My goals, besides reversing T2D, are body fat loss, and general good health (family history of heart disease). Here is what has happened so far:
As of my doc appointment in late February (when diagnosed), I weighed 265. As of last Thursday, I weighed 258.6. This morning I weighed 248.0. Last Thursday, my BMI was 40.6. This morning it was 38.9. Last Thursday, my body fat was 43.3, this morning, 40.8.
I simply want to make sure that I am not damaging something in some other way. While I love the weightloss, and the belt notch tightening, I don’t want to do it at the risk of some other terrible damage. I want to be healthy in all ways, and if that means the fat loss is not as quick as I’d prefer, that is okay. I can’t seem to get a handle on the low blood sugar reasons.
Thank you, OZ. When I read up, the various articles said that -while it is rare for Type 2- that it can occur. The problem is, they didn’t address the blood sugar aspect of it for Type 2 (as in, if it’s such and such low, see a doctor). Perhaps it’s because they just presume Type 2 is never going to have that low of a blood sugar? How likely is it that my blood test from the doc appointment last month could be wrong? It’s mind-boggling to wade through my unique circumstances.
Thanks much, Paul, as always. The only medication I am currently taking -and I’ve had to half the dosage since beginning Keto, due to low BP- is Lisinopril. I am not sure if that has SGLT-2 inhibitor or not?
KCKO = Keep Calm and Keto On!
It’s our motto.
Not to be confused with
Keeping Carbs is Keeping Obesity (which I just made up)
Or Kale-Chocolate is Keto Overreach
I’m impressed with your progress, feeling pretty good and gradually feeling better, well done you! Your body deciding to use up some fat stores shows you’ve changed your hormonal signalling.
So KCKO
Time wise, there are changes in the first 2 weeks, then probably more adaptation by 6weeks or 3 months. It depends on the individual. Some athletes, who push their bodies to a limit of performance, speak of performance improvements over 6 months.
In a practical sense, perhaps the next adaptation to look forward to is blood ketones dropping as the body gets better at utilising them. Other changes can be a feeling of brain calm and clarity and an inner supply of energy that doesn’t run out, even when there isn’t access to food. Everyone’s journey is different
