Gestational diabetes and ketones

[Rubyroost]

So recently diagnosed and was measuring my blood sugar levels with a monitor I already had. Everytime I had a small amount of carbs my blood sugar was high. So I spent the weekend before I went to diabetes clinic having very small amounts of carbs. Then turns out I have ketones in urine, my consuktant after I saw a diabetes doctor said nothing to do with diabetes. But I looked it up and it does. It can mean one of two things high blood sugar or not enough carbs. I think it will be the latter but I've run out of strips and get a proper monitor in weds. Anyone any experience of this? Thanks

Hi, I’m no expert but I have type 1 diabetes so some experience. Ketones can be in your blood after eating a high fat meal as well, this would happen to someone who doesn’t have diabetes as well. It might be that the levels in your blood were very low. Anything below 0.5 isn’t to be worried about and is just the body metabolising fat.

If the consultant wasn’t concerned you shouldn’t be either.

If carbs are making your blood sugar high, try combining fat with low GI carbs which will slow down the release of the carbs.

Thanks for your reply. They said the ketones were plus 3 whatever that means, so I think fairly high. Yes I'm trying with the low gis, but anything with carb in it is making my levels rocket. Eg had chicken with a bit of sweet potato (not even much) and my levels were 8 after two hours

8 is not awful two hours after eating. I think the guidance is 7.8 two hours after food. To be at 8 is absolutely no difference, if I did a finger prick test now and did it 20 seconds later It would be 0.2 difference. An 8 blood sugar will not cause ketones. Trust me, I test around 80 times a day and do ketones testing every day.

It sounds like you are being too harsh on yourself and your expectations are too high of yourself. Which is totally understandable.

The only thing I would say is if you are having chicken and potatoes for dinner which is super healthy, you might consider adding something like a cream sauce to it or some cheese as the fat will mean the carb is absorbed more slowly.

@LH1987 Thanks for that. Yeah I think the guidance for gestational diabetes is really low because the extra glucose goes to your baby. So initially I was thinking that's not bad, right?! But they want you to be around 5s most of the time I believe. Thanks for your tips on creamy sauce. That'll make my dinner nicer! I had chicken with mozarella and Pesto tonight that was alright. Is normal cheddar cheese okay to eat with stuff?

So they do want you to have an average of around 6 a day. It doesn’t matter what kind of diabetes you have the affect of sugar in the blood is the same on the baby. There is no way you can have any carbs with your dinner and have a blood sugar of 5 afterwards. Two hours after your meal you would expect it to be a bit up To around 7.8 and then to drop to between 4.1 and 5.5 before your next meal.

Yes cheddar cheese is great, I also find peanut butter and peanuts are great and really low carb but full of fat. If you fancy fruit, apple dipped in peanut butter works for me!

Thanks for the tips. What about snacks? Do I need to have these? And if so do you have any recommendations when and what? Thanks so much for your advice, it really is helpful and much appreciated.

The target rates for gestational diabetes are lower than for other diabetes: usually 7.8 or less one hour after a meal, or 6.4 two hours afterwards, and fasting levels below 5.3. It sounds as though you might need some more advice from your hospital.

I learnt a lot about food pairing while figuring out how to eat with GD - in particular, eat any carbs with protein and fat to avoid the sugar spike. You'll need some carbs for your and your baby's health, so going completely carb-free is not recommended - and if your levels won't fall into the range they might at some point recommend insulin or Metformin.

There is a really useful Facebook group (called something like Gestational Diabetes support group) where people are sharing loads of tips and experience.

Thanks @nopun I'll take a look at that Facebook group, definitely looks useful. Yes I have looked the targets up. I will be on metaformin soon as I'm eating healthily and any carb significantly raises blood sugar. I'll be on meds as I've been diagnosed late and Dr wants to act straight away rather than figuring out what works. At the moment the only thing which seems to work is barely any carbs at all which means I'm not getting my calorie intake.

Sorry for saying obvious things - from your original post I didn't know how much you knew. I remember feeling quite bewildered by everything at the start (and still do sometimes). One other thing I learnt is that it's best not to let yourself get properly hungry - snacks and small meals throughout the day definitely help to counter sugar spikes. But mostly eat some protein with every portion of carb you have. The Facebook group will be a good place to ask about ketones.

Yeah I understand @nopun I didn't make it clear, did I. Im juts not used to having snacks. I've got. Myself some nuts. I guess it's a start, this is a whole new lifestyle change for me. I've now been diagnosed with polydriamnos too. It's 31cm 😬

@Rubyroost hi, I was just diagnosed yesterday. My fasting result was 5.6 and the cut off is 5.5 and my post glucose was 7.7 cut off 7.8 so based on the fasting result they are treating me for it.

They told me to go back on Tuesday to collect a blood glucose monitor which I will do. My dad is a retired GP and also has type 2 diabetes so I've been using his monitor.

I was wondering what range they told you to try and stick to pre and post meals?

I checked mine two hours after some roast chicken and 5 potato wedges last night and it was 7.5. Checked it this morning as hadn't eaten since 8pm last night and got 6.1 rechecked and got 5.5.

My dad seems to this this is ok but according to the nice guidelines it's not haha!

Xxx

@Rubyroost I’m on my 3rd GD Pregnancy (I also developed type 2 after baby 2 but this current pregnancy sent my readings into the stratosphere). I’d also recommend the GDUK mums Facebook group and website - lots of useful info including about ketones. I sometimes have ketones in my urine (for me it’s from not enough carbs - at the moment I am on Metformin and insulin because it’s so hard for me to tolerate any carbs at all) BUT something to bear in mind is that urine ketones are pretty unreliable and blood ketones is a much better measurement. Eg I had +2 in urine the other day and 0 in blood. My clinic have now given me a blood ketone monitor (works the same as the usual fingerpicker) which I’ve found very reassuring as it’s shown that I’m getting the balance right. Not sure what the criteria are for getting given a blood ketone monitor but if you have urine ketones at your next appointment see if they’ll test your blood too.

@sredwards they've just said after meals 7.8 and fasting 5.4 or under. I'm not happy with the 7.8 after meals though and I'm aiming for 6.5 after meals. They've given me the general guidelines, but I've heard and read that the guidelines fir gestational diabetes should be stricter. I've joinebldbthe Facebook group @Secondsop and it's really useful, thanks for the info re ketones. My bloods are under control at the mo, but I've found carbs at breakfast can affect them more than I'd like. Now I'm just worried about my polyhydramnios, if I get any bigger I feel like my waters will burst early. 😭

@Rubyroost do you test 1 hour or 2 hours after eating? Xxx

About 1 hour 15

@Rubyroost breakfast is notoriously hard to manage and lots of us GD ladies have hardly any carbs then or a no-carb breakfast. If you get sick of eggs I like a little full fat greek yoghurt with keto muesli.

@Rubyroost

I looked at the NICE guidelines on blood sugar targets. I noticed it I check mine one hour after eating in within range but 2 hours who used be 6.4 or less and usually slightly out of range.

Have you found any difference is the time to leave after meals to test? XX

@sredwards I don't tend to test two hours anymore as my 1 hour 20 min tests are well within range currently. I'm not eating loads of carbs and they've put me straight on to metaformin so it seems I'm pretty controlled at the mo. Today I had a piece of wholemeal toast with breakfast and a piece of wholemeal toast with lunch and that's all the carbs I've had. Before the meds kicked in I could only eat a no carb breakfast. Last night I dared to have some mashed potato but just a small amount and all went okay. Prior to this I've been eating weird grains like chickpeas and lentils and brown rice and lentils etc. Definitely join the facebook group UK diabetes or something... Theres loads of ladies there that have gone through this much longer than me and they know their stuff. X

@sredwards this is really good, explains a lot Inc spike testibg
www.gestationaldiabetes.co.uk/blood-sugar-levels/