Hand holding needed: ketones in urine

[Surya]

Am 36 weeks, and was diagnosed with gestational diabetes at 33 weeks. I was quite chuffed that I've managed to control my glucose levels with diet and exercise, and today's ultrasound scan found that the baby isn't too big at all, and instead on the small side (husband and I aren't big either, and apparently Indian babies are frequently smaller).

So all was sunny and happy until we went to the midwife-led unit, one of the birth options we were considering. I did the obligatory peeing in a pot, and the midwife (who hadn't read my file yet, and so didn't know about the GD) wanted to know why I had high levels of ketones in my urine. I suggested that this might have to do with the fewer carbohydrates I was eating, and she seemed satisfied by this.

But now I can't stop worrying! What does it mean to have ketones in your urine while pregnant ? I'm vegetarian, so its not like I've been eating nothing but steak, and my meals all include some carb. So why do I have the urine of a hard-core Atkinser ? Maybe its just because I had a late breakfast ? And surely the diabetes specialist midwife I've been seeing frequently and peeing for even more frequently would also have been testing for ketones, and would have found anything to be found ?

Please slap me around the chops and tell me to stop worrying. Or alternatively, tell me the about the terrible things this might be the portent too.

I've had ketones in my urine a couple of time, the midwife just asked what I'd eaten that day and it was just that I hadn't eaten a lot before doing my sample, she said it tends to indicate a little bit of weight loss.

I would mention it to your GD midwife if you're worried. But I haven't been worried about my ketones.

It just means your body is burning it's fat supplies and you may need to eat more.

I had it with dd1 and laughed when the midwife told me I needed to eat more, but hadn't had breakfast before the test. So it can be just missing a meal.

I had ketones pop up in early labour because I'd had D and V for a few days I.e. 'the clearout'. Are you eating and drinking enough?

I'm eating and drinking loads, including a big lunch just before the suspect urine test, and a late but substantial (fried mushrooms, a hash brown, and a boiled egg) breakfast. But eating more, I can do, yes sirree!

I'm going to attribute the ketones to a late breakfast and ordering some pizza now...

If you only had one hash brown with breakfast and no other carbs, that might be why. I have GD and have been told to have at least 180g of carbs a day.

Can you phone the dietician?

i had this and the midwife questioned it its happened on 2 occassions for me first time was i had real bad sickness and food adversions and couldnt barely eat enough to feed a mouse let alone myself and baby midwife took that info fine and was told to go on tablets for the sickness if it didnt get any better second time was because i hadent eaten before the sample and it was a early midwife appointment not happened since to me id try eat more food if you can

Depending on the level of ketones, you probably need to eat more carbs (even if this means you can't diet control and have to have medication). It's a balance between eating some carbs (so baby grows well) and not eating too many (so sugars don't get too high). Can you phone your diabetes specialist midwife for advice?

Hmm, a dietician hasn't even been mentioned to me. I do eat quite carby meals for dinner, because I have fewer sugar spikes in the evening compared to the morning. Will call the midwife on Tuesday then

I've had ketones 2+ at my last few checks. The MW has always asked if I've eaten that day, and I always have - at the last one she just said that the babies must be taking everything I'm eating. No one has been concerned at all.