Normal blood sugars large ketones (ongoing for 3 weeks)

Hi everyone!
I am just looking for some insight or advice on what to do or what’s going on. I started getting moderate to large ketones on and off at the end of December. I had a stressful/traumatic kind of life event occur and I think it started to affect my normal levels of stress and anxiety. So basically from the end of December until now I would have a day or two days with moderate to large ketones and then a day with small ketones and then a few days (2-3) with trace or none and then the cycle would start back up. I can tell when I have ketones because I am extremely tired or moody or just overall not feeling like myself. I do not think there is another sickness causing the ketones. My blood sugars have been normal mostly, with some more constant low blood sugars. I contacted my doctor on Friday because Thursday I had moderate ketones and told her what was going on and she just said that I only need to be concerned if I am vomiting. I have large ketones today and I can definitely feel it and I’m just worried about going into DKA because of how regular of a pattern this is and I am not sure if I should go in.

I don’t have any insight to give you, but can only share that when I have ketones no amount of insulin will bring them down until I wash them out of my system with water or some other sugar free liquid.
I’m sorry to hear about your stresses and hope things settle down for you soon.

you can get ketones with normal blood sugar anytime you are losing weight (not enough calories intake). When you are losing weight your body is burning fat, and burning fat will cause ketones.

in times of stress, some folks don’t eat as much or forget to eat. Has your calorie intake changed at all? Have you lost a little weight? Of course, you should consult with a doctor.


It is nice to see you back here Autumn @Autumn_Rose, but I do wish it could have been a more positive visit.

High BGL and high ketone level do not have to appear together although they often do. Ketones may appear for other reasons such as, stress which you were experiencing, diet - some foods (think keto diet), intended weight loss, and even from exercise.

I think your doctor’s assessment is okay at this time without doing a detailed examination, but please call her back if you encounter any changes - or more concern. Recall that ketones (or acidosis) appear as the body breaks itself down - aka, “burning fat”, often when there isn’t sufficient insulin present to enable the body to effectively use the foods you eat - that is what has been called diabetes mellitus, or the “Wasting Disease” in prior centuries.

Thank you for the help!

ok, thanks for the help!

hi! I haven’t lost much weight but my food intake is a bit different every day so there are probably days where i’m eating less than I should because of work or if I’m feeling more stressed.


Here are two articles about euglycemic ketosis or ketoacidosis. Strange, some people are positive for ketones with normal glucose and normal acid/base balance while others will have have acidotic ketosis.

Hi Autumn,
Sorry to hear about your situation with mod to high ketones, despite normal BG numbers. Is there any way that you could get a blood draw by your endo while you are experiencing a mod to high ketones incident? Maybe they could check all your other numbers and catch what is going on? Good luck!

Hi @Autumn_Rose . Have you had any luck from the responses? It occurred to me that the body burns ketones when it has to use its own fat stores for energy sure to not getting enough carbs. I think some people wake up with small amounts of ketones because they’re fasting overnight. Someone mentored the keto diet but even if you’re not following that it might be worthwhile to check to make sure you’re getting enough nourishment.

hi Tom!
I have an appointment with my endo in about 2 weeks so I’m hoping they can do a blood draw since I still have ketones maybe they will catch something. Thanks for the advice!

Hi Dorie,
My sister also mentioned that it could be from not enough carbs so I’m gonna try to not skip meals and see if that helps. Thanks for the help!

Thanks for the articles!

I see mine on Weds and your question prompted a question for me to ask her. I feel like I should know this but since I’ve had very few issues with ketones I haven’t really given it much thought. But I do want to ask her about ketosis - where your body uses its own fat for nourishment - and DKA - and whether the former “converts” to the latter for us Type 1s.

I see you’ve gotten some articles already. I found another one, and here’s an excerpt:

Thus, the main difference between nutritional ketosis and diabetic ketoacidosis is as follows:

** In ketosis, only ketone levels are elevated, allowing your body to use mostly fat for energy.*
** In diabetic ketoacidosis, blood sugar and ketone levels are very high, resulting in a critical health state.*

It sounds like they are two separate “phenomena” (for lack of a better word) but it will make for a good discussion and I do enjoy discussions with my endo.
If you are doing a keto diet - intentionally or otherwise - you might want to speak with your dietitian for an alternative or to see if there are ways we Type 1s (or anyone else for that matter?) can do it safely.
All the best to you!

Dorie @wadawabbit, for your research and study on this ketone, acidosis know that acetone, a significant poison, is a biproduct of the body burning its fat when it [the body] is being starved because of lack of usable insulin. Recall that in my first post under this Topic, mentioned body starvation, i.e., eating too little and thus reducing insulin. Recall too in your early days you put one drop of your urine on a small Acetest [? sp.] tablet to see how the color would change to determine how badly you were being poisoned.

Next time you are on the paint aisle of the hardware store pick up a can of acetone, read the warnings and notice the aroma - very similar to the breath of people losing weight by diet.

Thank you @Dennis ! I had a feeling I would get a response from you - thanks much.

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