Large ketones-normal blood sugars

Hey guys,
So I have been feeling a little off lately but recently I have been extremely hungry which seemed kind of out of place. This morning I felt really off so I thought I would check my ketone level just to rule anything out but unfortunately It showed levels of large ketones. My blood sugars are great, actually I had An appointment with my endo 2 weeks ago and she said everything looked great and I could wait 6 months to schedule a follow up.
So I Guess Im not sure what could be’ causing this and whether or not I should go into urgent care or wait till tomorrow and see what my endocrinologist says.
Thanks in advance for the help✌

I’m not an expert but from my sisters experience I can tell you that her endo told her to purposely elevate her blood sugar to over 200 so that she could have an insulin correction shot to bring down her ketones. For my sister she had to be giving herself insulin every three hours if she still had ketones. Now that’s for my sister so please don’t follow these same steps before getting guidance from a doctor. If the ketones last for a long time do seek professional help. What I can tell you that will help you is to drink plenty of water. I’m so sorry, hope this helps you.

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I suggest you call your doctor’s office - the answering service should be able to reach your doctor or the on call physician. I second the advice to drink plenty of water or sugar free beverage to try to wash them out. That usually works for me (in addition to insulin but your numbers are good).
Just wondering if your test strips are up to date? I rarely need to use them and they can outlast their life span.
Another possibility is an infection, perhaps internal. Mine show with my numbers first then ketones, but that may not be the case.every time. If you have any toothache check in with your dentist.

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@Autumn_Rose whenever your body is burning fat, you are making ketones. If you were testing basal rates and not eating, you will make ketones. Whenever you are on a calorie diet, you will make ketones. When you begin a “keto” diet, you will make ketones. Overnight, you will make ketones. Whenever you WANT to lose weight, ketones are a sign you are moving in the right direction.

If you don’t have insulin available, your blood sugar rises but can’t be used by your muscles. Your body burns fat to make the energy it needs. This is most often accompanied by high to very high blood sugar. Large ketones with little to no available insulin and high blood sugar can create a runaway chemical reaction we call diabetic ketoacidosis … DKA. This is bad. This needs an emergency room typically to get IV fluids and your blood sugar under control while maintaining blood pH. Or you could die.

They only really talk about DKA and it gives the impression that “ketones are bad and need to be avoided at all costs”. Maybe so in growing kids, but not necessarily so in adults maintaining weight.

Of course check in with a doctor. If you feel nauseated or throw up, emergency room. Good luck :four_leaf_clover:


First of all thanks for all the advice!
Yes I did check the expiration date on the strips and they dont expire for another few months. I left my doctor a message for now. Right now theyre more in the moderate to small range.

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Keep drinking water or other SF/caffeine free beverage, and keep checking those ketone levels until you hear back from the endo on call. And tell us what they said, would you? I hope you’re starting to feel better, too!

Hi Autumn @Autumn_Rose , @Joe gave a good synopsis of ketone so I won’t repeat. I’m not a physician so my suggestion is based on my experience with diabetes.

As to going to Urgent Care now or waiting for the doctor who knows your condition, I say wait for your doctor’s call - there is about a 1 in 48 chance [a wild guess] you will get someone at Urgent who would understand. The fact that your body is hungry for food concerns me; that is a primary sign of “uncontrolled diabetes” which your BGL somewhat contradicts. Your doctor will guide you through this investigation.

I wish you well.

It sounds like they’re coming down, which is great. When I had COVID a few months ago (mild case, stayed at home) I had virtually NO appetite and my body was burning its fat supplies so I had some mild ketones, which is not unexpected for not eating for a very long time. Keep checking them and drinking sugar free as you wait for your doctor - hopefully they’ll keep dropping and you’ll just need to figure out what caused them in the first place. Keep us posted!

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Yes, will do, THANK YOU!

Good morning - checking in and hoping things are much better.

Hi! Ketones are back to small, thanks for checking in!