Ketones

The two previous pages discussed several problems that people with diabetes have to deal with. The other major issue is ketones.

What are ketones?

Ketones (pronounced key-tones) are produced when your body gets energy by breaking down fat instead of sugar. This can happen for one of two reasons, if you do not have enough insulin in your blood, or if there simply isnÃât enough sugar available. In people who do not have diabetes, a low level of ketones is normal, and not harmful. They appear if you haven't eaten for a while and after prolonged exercise. In people without diabetes, glucose, insulin and ketones work together to supply the body with the energy it needs.

In diabetes, ketones are produced when blood glucose is not well controlled.

What is diabetic ketoacidosis?

Ketones are acidic. A low level of ketones will not have much effect, but as the levels increase, and the blood contains a significant level, it will become acidic. The name for this is diabetic ketoacidosis (DKA).

Diabetic ketoacidosis is a significant risk for insulin users. At very high ketone levels, DKA requires emergency medical treatment. If untreated it can be fatal.

The first signs of DKA are increased urination and thirst, while later symptoms include nausea and vomiting which can lead to dehydration.

Who is at risk of DKA?

DKA can happen in any insulin user. However, illness is the most likely time for ketone levels to rise because insufficient insulin is being taken to balance rising glucose levels. Missing insulin doses for other reasons can also raise the risk.

This booklet gives advice about managing your diabetes during illness in a later section.

If you have a meter that can test for ketones then it is important to know how to test and when to test. Additionally, good blood glucose control - balancing food, insulin and blood glucose testing - minimises the risk.

Remember - ketones are serious, but good blood glucose management takes care of ketones as well