What else do they do?

Bottle and Box of KetostixKetones.

We know that ketones are bad, and usually a sign that something has gone wrong with your insulin delivery.

However, there are times where the normal metabolism processes will also cause ketones, even when your insulin delivery is just fine.

When your cells can’t get the energy they need through available glucose in your bloodstream, your body will start to break down fatty acids. A by-product of this process is ketones. I’m not a doctor, or even a medical professional, so there are many more accurate descriptions of the process available. My basic understanding for the purpose of this post is that when the body has to turn to fat stores for it’s energy, you will have some ketones.

Yesterday was a basketball day for me (where I play ball for about 2 hours over lunchtime). I had eaten a bagel with cream cheese and a glazed doughnut for breakfast. I also had two bottles of juice during basketball to keep my bloodsugar up. My bloodsugar hovered between 74 at it’s lowest, and 107 at it’s highest (pretty damn good!). When I left the gym after showering and dressing, I tested 105. I felt good. I worked really hard during basketball and had an excellent workout. I was however very dehydrated – even before basketball. This is thanks in part to my official addiction to Diet Coke (caffeinated – a diuretic), and also the fact that I had not taken in much water in the past few days. I did drink 32oz of water during basketball, but I’m sure it did not “equal out”. I sweat like a stuffed pig in a sauna, and probably lost 64oz of water through that alone.

I got back to work and felt really really worn out. I naturally just thought that it was because I worked really hard. I really pushed it today, much more than usual. So, of course I should feel a bit spent. It made sense. I was also immediately completely bombarded by work stuff – more so than usual after being away from my luxurious cube for a couple hours.

About 30 minutes later my muscles felt “funny”, and my blood sugar had spiked up to 247 (with no food!!)! I had suspicions at that point that I was spilling ketones like a two year old using a “grown up cup”.

I was again distracted by work stuff, and would you believe I totally forgot to correct for that 247?! It was another hour before it hit me that I had forgotten to take a correction bolus – I did another test to get an accurate reading, and by this time was up to 268. I corrected for that, found a ketostix and proceeded to the bathroom.

Remember the dehydration thing? Yeah.

I managed to produce a sample and the ketostix immediately turned a dark purple. Large ketones.

It’s now 4:00pm. My breakfast was at around 9:00am, and the two juices I had were between 11:30am & 12:30pm. With basketball usually burning an insane amount of calories (2000+, I have worn my heart rate monitor a time or two), and me not having eaten very many calories, it’s no wonder that my body was burning fat stores to survive. That’s actually the point of all the exercise isn’t it (well, that & to get the heart pumping)?

The issue with the presence of ketones is it makes you a bit more resistant to insulin. That’s why my blood sugar was rising. If I would have known about the ketones I could have increased my insulin to balance the resistance. I now also need to flush the ketones out (lots of drinking water & peeing), and get my body to stop producing them by feeding it (so it stops burning fat for energy).

It’s manageable, and information is the key. By (my) suppertime later that evening (7 or 8 o’clock) I was back down to 84 and managing just fine. Still working to flush the ketones, but blood sugar control was doing fine.

But I was totally & completely wiped out. In part because I really exerted myself at basketball, and in part from running high that afternoon, but I’m also convinced that all those ketones in my system also contributed to my exhaustion. I know that they can upset the acid balance of your chemistry, which can’t be good. But what else do they do? How do ketones interact with your body? What trouble do they cause? Why do they make my muscles feel funny? What would happen if you spent an extended period of time with ketones in your system – managing blood sugars with more insulin?

I believe that a non-diabetic person can deal with them a little better because their pancreas will automatically match their higher insulin needs (ketones make them resistant too – but their pancreas just creates more insulin). But, don’t they still deal with needing to flush them out of their system, and their acid balance should be thrown out of balance too right? How about when the Atkins diet was all the rage, and people were using ketostix to see if their diet was working or not – didn’t they feel crappy with high ketones? Or is it different for a non-diabetic? Does their body do something besides the increased insulin to deal with them?

What else do ketones do? That is the question of the day.

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Scott K. Johnson

Patient voice, speaker, writer, advocate. Living life with diabetes and telling my story. Patient Success Manager, USA for mySugr (All opinions expressed are my own and do not necessarily represent the position of my employer).

Diagnosed in April of 1980, I recognize the incredible mental struggle of living with diabetes. Read more…