MEDICAL DIRECTORS CORNER: 15 FAST FACTS ABOUT KETONES 1. Ketones are chemical by products when fat tissue is consumed for energy. They are produced in all mammalian life forms. 2. A small amount of ketones are created each day in every human being when they sleep and havent eaten for a few hours. 3. They are not spelled with a y. Spelled KETONES. 4. They are actually a family of chemicals which possess qualities of weak acids. Under normal conditions they dont disrupt body chemistry. This only happens when theyre produced in large amounts such as in persons with uncontrolled type 1 diabetes. 5. They are themselves an energy source for human tissue. The brain can use ketones during periods of fasting or starvation. 6. The creation of ketones in humans is largely controlled by the balance between insulin and anti-insulin hormones, better known as stress hormones. 7. Under normal conditions, it takes about one tenth of the amount of insulin to suppress ketone formation than it does to control sugar levels in the blood. This is why blood sugar levels can be very high in diabetics but ketones still low or negative. 8. When treating excess ketones, they can be metabolized back to other useful substances by the body when insulin is present, exhaled through the lungs (acetone) or excreted in the urine. 9. Maintaining good hydration is one way to rid the body of ketones. But having sufficient insulin present to stop excess ketone formation is essential. 10. Insulin therapy will control blood sugar levels faster than it will clear away excess ketones. This is why they take longer to eliminate when both sugar levels and ketones are high in the bloodstream. Know your diabetes sick day rules well! 11. Ketones and other byproducts of fat breakdown can cause nausea and vomiting when the process is uncontrolled. Its not the ketones themselves that are responsible, rather...chemicals known as prostaglandins. These can disrupt the normal process of peristalsis in the intestines, resulting in nausea and vomiting. 12. If vomiting occurs during periods of high ketone and sugar levels, the dehydration which follows will concentrate sugar levels further, amplify the ketone levels and generate other body acids. This is the basis of diabetic ketoacidosis or DKA. 13. No person with type 1 diabetes is immune to developing ketones no matter how rarely they report measuring ketones. This is due to the fact it takes a fairly prolonged lack of insulin combined with anti-insulin stress hormones. If insulin is forgotten, omitted or delayed during an illness, this could be enough to trigger DKA or at least the first steps towards it. Ketone-denial can be harmful to ones wellbeing. 14. Ketones can be measured in urine or blood at home. Know what levels require careful follow up and which ones require immediate action. In general a blood ketone level of 1.6 mmol requires action. If measuring urine, a moderate or large amount on dipstick necessitates action. What exact action is taken depends on your unique care plan. The general concept is best known as Diabetes Sick Day management. But remember...you dont have to be sick to develop ketones in excess. A missed injection or insulin pump malfunction will do it. Or use of high doses of steroids while still getting insulin. There are several possible causes. 15. Ketones can be detected by smell. The ketone called acetone (nail polish remover) is removed through the lungs. A person with ketones may have a sweet fruity odor to their breath. The acid load in their body may also make them take longer deeper breaths in an attempt to remove ketones faster. This is called Kussmaul breathing, after the doctor who first described it.
Posted on: Tue, 05 Aug 2014 05:20:32 +0000
Trending Topics
Recently Viewed Topics
© 2015