High keytones in urine - home dip test

[OhWhatAPalaver]

Do I need to go to the out of hours drs? I thought I had a uti as I have been prone to them in the past but the dip test showed up high keytones and some leukocytes. No nitrites or protein. My bladder and bowels have been playing up for a week or so but now I'm weeing a lot more than usual. Google scared me re: keytones but have also read that people who are dieting aim to have them so I'm confused... My dad is type one diabetic so it's worrying. I don't have the unquenchable thirst though. Slight nausea but could be because I'm quite stressed at the moment as well. Can anyone help? Thanks.

Should add, I have a drs appointment tomorrow at 7pm so if not urgent I could wait till then.

Wait til tomorrow. Ketones show in urine hours later could be starvation ketones from overnight.

Call 111 and ask. Write down how much you are drinking, it might be more then you think. Don't go thirsty, drink as much as you like, with either a UTI or diabetes it would be good to stay hydrated.

Thanks. I'm deliberately drinking a lot just in case it is a uti.

Are you in any pain?
If not I would wait until the drs tomorrow

I'm going call 111 I think as I've done 3 tests now and they've all been off the scale for ketones. Not in a huge amount of pain, more just discomfort really.

can you go test your sugar on your dad's machine?

Have some carbs ...that'll reduce your ketones !!! Mum of DS on medical ketogenic diet!

If this isn't normal for you then you're right to call 111 for professional advice, hope you're ok.

Did the dipstick show any glucose? Could you do a finger prick test e.g. on your dad's monitor? If it is type one and you have high ketones, you need to go to hospital immediately.

@icebearrocks - in people with type one diabetes the problem is generally the lack of insulin rather than lack of carbs (although people can get moderate starvation ketones). Unless they are treated appropriately with insulin they can go into DKA which is a serious, immediate medical emergency (life threatening).

Ketonuria is common in starvation /stressed states and is not just a diabetic ‘thing’. In someone who’s not diabetic it’s not a big problem on its own - hydration/nutrition (including carbs) and managing the uti/whatever else is causing the stressed state is the management. In someone who is known to have diabetes it can be a sign of very badly controlled diabetes and that does require urgent management (people with diabetic ketoacidosis are usually barn door obviously sick due to dehydration).

What did 111 say?

@ohwhatapalaver - hope you are ok this morning?

@walkingthroughawall - DKA can occur in a person with type one diabetes (or rarely type two) at anytime the insulin requirements aren't met e.g. through pump or injection failure, periods of illness or growth etc. It can also happen if people omit their insulin for whatever reason. Health professionals are being encouraged to stop using terms like "very badly controlled diabetes" as they are a bit unhelpful and judgmental.

@t1mum3 being an HCP that regularly manages diabetic ketoacidosis (in intensive care) I’m familiar with the basics thanks. Health professionals are also ‘told’ not to use jargon and given that DKA is vanishingly unlikely to be the underlying problem here it didn’t seem appropriate to start using ‘the lingo’. ‘Badly controlled’ would also be factually true and has nothing to do with judging people but reflects that many things can mean diabetes becomes uncontrolled.

As an HCP dealing with DKA are you familiar with this document from NHS England? www.england.nhs.uk/wp-content/uploads/2018/06/language-matters.pdf Also, I'm not sure how you conclude that DKA is vanishingly unlikely to be the issue in someone with a direct family history of type one diabetes in the absence of information about their glucose levels. You will of course be aware of the frequency of DKA (and near DKA) at diagnosis for people with type one diabetes.

Should HCP even be giving advice on a forum?

Sorry for the delay in replying. Turns out my test strips were out of date and therefore faulty. Thanks for the detailed responses everyone. There was no glucose showing up and saw a gp yesterday who has sent off a urine sample. She didn't do a dip test though so I've ordered some more test strips for my own sanity. I have no other symptoms of diabetes, ie. Increased thirst etc so I'm thinking the weeing more often is bladder/pelvic floor related. Thanks again for the replies.

@ohwhatapalaver - really pleased to hear that everything sounds like it's ok. Bit poor of the GP only to send the urine off for analysis (rather than doing a finger prick then and there) but sounds like you are feeling well in yourself.

I always get pretty high ketones, protein and leukocytes in urine samples. About 60% of the time I have a load of blood too (not visible!).

I hope that's some reassurance - nobody seems hugely worried about me and it's been the case for quite a while! I think I just have higher levels than standard.