Wednesday, March 13, 2013

The Chicken or The Egg . . . .

ChickenEggSometimes diabetes reminds me of the age old question “What came first, the chicken or the egg?”.  In diabetes lingo I’m pondering “What came first, the ketones or the crud?”.

Last night I went to another JDRF Type 1 Adult event, and it was fantastic!  (Hopefully I’ll get a post up about it soon . . . . )  While there, I had my favorite salad and some wine.  This particular salad is always a tricky bolus for me, because it contains candied walnuts and a honey dressing.  To make things trickier, sometimes the salad seems loaded with walnuts and at other times it has less (and sometimes Pete snags a few off my plate and at other times he cons me out of more than a few).  Basically I do my best SWAG bolus and adjust later if necessary.  Before bed I needed about a half unit correction and that seemed fine.

Fast forward to 4:30 a.m. when I woke up feeling cruddy.  I didn’t have a CGM sensor on because I’d decided to take a rare few days off, so I got up to test my blood sugar.  I was shocked to see 273 glaring back at me!  Even with the candied walnuts, popping a number in the 270s after that salad was crazy.  I bolused my correction, drank some water and tried to go back to sleep.  By 7:00 a.m. I was feeling really sick to my stomach.  I managed to hold things together and when I dragged myself out of bed and tested, I was happy to see I was back down to 144.

Unfortunately that didn’t last long.  A couple hours later I was back up to 259 despite the fact that I felt too icky to eat anything.  It occurred to me that I should check for ketones, and sure enough the strip quickly turned that pretty purple shade indicating Moderate.  So I’m drinking lots of water, I took my correction by injection, and I’m trying to eat a little something.  I've also happily ended my CGM vacation and fired up a new sensor, grateful to be able to keep close track of what is going on. 

But I can’t help wondering, do I have ketones because I feel sick?  Or do I feel sick because I have ketones?  If the injection brings me back into range, I’ll change out my site and see if that clears up the highs and the ketones, and hopefully the queasiness.  And I suppose I’ll have my answer.  But right now I’m in the endless chicken / egg circle of wondering what came first, the ketones or the crud?


  1. Dagnabbit :-/ I blame the time change, been wacky all week! Hope you're better!

  2. Yuck... hope you're doing better very soon.

  3. Ketones confuse the hell out of me. I don't have any experience with them and reading other peoples' experiences of them make me very apprehensive about when that day comes....

    Sorry to hear about the bad experience and hoping for the best from here on out!

  4. Sure hope you're feeling better this evening!

  5. Oh man, that sounds miserable, Karen. I hope you're feeling better.

    As for which came first? Who knows. Both crud and ketones, each on their own, throw everything out of whack.

  6. I hope you feel sick because you have ketones. But where did the ketones come from? I always read about this yet for some reason it never seems to sink in for me. Often I feel nauseated (way too often) and yet my BG is normal. I never think to test for ketones when I feel that way because I always associate ketones with high BG. I always disregard the fact that they can happen with normal BG.

    I really think this post has made me more aware and hopefully next time I feel icky I'll remember to test my ketones.



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