What’s a ketone?
In medicine, it’s applied to the chemical acids produced by the body when it has insufficient insulin levels in the blood to metabolise glucose to fuel its cells. If this happens, your body starts to burn up its own fat and, as a result as part of the biochemical reaction needed, ketone bodies will be produced. This is a common complication related to diabetes, particularly in Type 1 or advanced Type 2 diabetes.
How does this happen?
When you don’t get enough insulin, your body can’t transfer glucose from your blood into your cells to use as energy and must look for a replacement. Your liver can convert its fatty acids into ketones, which can be used as an alternative source of energy. Ketones are generally present in your body at a low level because they are produced whenever you burn body fat through exercise. In people with diabetes, excess ketone levels can pose a serious health risk.
Diabetes Ketoacidosis (DKA)
If you are insulin dependent, suffering from Type 1 or advanced Type 2 diabetes, excessive levels of ketones can result from insulin deficiency. If left untreated, a high level of ketones in the bloodstream can lead to a dangerous condition known as ketoacidosis, which causes coma and eventual death. Diabetic ketoacidosis (DKA) can occur during illness or if you take too little insulin, and is determined by high blood glucose and ketones detected in the blood and urine. If you think you might be suffering from an excessive level of ketones, you should contact your doctor or diabetes clinic as soon as possible.
How do I know if I have excess ketones?
The most accurate test for ketone levels is by means of a blood test, which you can perform at home. Some devices allow for testing glucose and ketones in your blood, and other devices could alert you of the potential presence of ketone bodies in your blood. You can also do a urine test, but this is less immediate as it will only register the ketone levels which existed a few hours previously.
Do I need to monitor my ketones?
If you are on insulin or are taking a type of drug called SGLT2 inhibitors (eg Jardiance®, Invokana® or Forxiga®), you might need to monitor your ketone levels and learn to recognise the symptoms of ketoacidosis which might indicate that your diabetes management needs a tweak. Please consult with your diabetologist and/or GP about testing for ketones.
Ketone testing is also important during pregnancy. If you are a person living with diabetes and on insulin, or even if you have gestational diabetes not treated with insulin, you should consult your doctor immediately if you experience any DKA symptoms. These may include dehydration, vomiting, rapid heartbeat, hyperventilation or deep laboured breathing, confusion, disorientation and a smell like pear drops or nail varnish on your breath.
This week we’re going to learn how to use the lancing device and a blood glucose meter, but most importantly I’m going to teach you some really useful tips that everybody should know.
Lancing devices are used to obtain a sample of blood usually from the finger for our blood glucose meter, here’s the first tip:
Wash your hands with warm water and normal soap before you begin and make sure you dry them, warming your hands gives the puncture site better blood flow so it’s easier to collect a sample, rubbing your hands also helps with this. To load the lancing device it’s pretty simple you first twist this cap off then you get yourself a lancet that hasn’t been used, pop it in so the grooves are in line. Next twist this cap off and now the needle is visible, so please be careful, next get the cap and pop it back on, twist it on and it should click and that’s it.
Use a new lancet every time you use your lancing device, I know it’s time-consuming but remember this every time you use your lancet the needle becomes dull so, one, it’s going to hurt more and two, you’re at risk of a skin infection. Next is the depth indicator, it adjusts how deep the lancet tip will go into your finger, now this isn’t something that I can teach you on a video you’ll have to do it a couple of times to get the correct setting for yourself.
This is what we call the pad of the finger, it has more nerve endings compared to the side so for less pain when using this go for the sides and switch fingers regularly to prevent thickening of the skin, if you’re still in pain when you’re using this then speak to your healthcare professional about getting thinner lancets, lastly pull the sliding barrel back so it locks into place, the spring-loaded lancet that we fitted earlier place it on your skin firmly and click the button so it releases the lancet to puncture your skin for the blood sample. So often I see patients blood glucose meters and their control solution has never even been opened, if you’re not testing your machine or your test strips how can you be sure you’re getting the right readings?
Perform a control solution test each time you open a new vial of test strips or you feel like your meter isn’t working properly, let’s say it’s giving unexpected results or you may have dropped it or damaged it, I’ve left more information in the description below about this, so continuing on from our lancing device part, to test our blood glucose we need to get few things ready, we need a glucose monitor, it’s specific test strips that are in date a primed and ready to use, lancing device which we did earlier, a cotton wool pad, a yellow sharps bin and a monitoring diary so we can put our results in at the end. Next, remove a test strip from the vial and insert it into your blood glucose meter, it should switch on at this point and warm up and it will tell you when it’s ready for your blood sample. Now, place the lancet device firmly on the side of your finger, press the release button and remove the device from the puncture site, warming up your hands makes it easier to get blood without applying pressure, if necessary apply very light pressure to the surrounding area until a blood drop appears, now wipe away the first drop of blood with a clean cotton swab, with the second drop of blood be careful not to smear it, make sure your meter is ready and gently touch the blood drop with the test strip to collect a blood sample. The test strip will draw the blood towards itself, after a few seconds the meter will display your blood glucose level, write this down with any other information in the monitoring diary or update your electronic records.
Diabetic patients tend to build up a collection of different blood glucose meters over the years, it’s really important to only ever use one blood glucose meter to build up a trend of results, if you’re going to use different machines you’re going to end up with slightly different results and that’s not a good thing.
That’s how it’s done, one last thing before I go, make sure to remove your used test strips and lancet and put them in your yellow sharps bin, the safest way to remove your lancet is by placing the lancet cap on a hard surface and pushing the lancet needle into it now it’s no longer exposed and easy to remove. Let me know how you get on with my guide by leaving a comment below because I’d love to read it, thanks.
Diabetes is a condition which occurs when a person’s blood sugar levels are too high for an extended period of time. High blood sugar is often a result of low insulin levels. There are two types of diabetes:
Type 1: This type is present from birth and is the result of the body’s immune system destroying the cells which produce insulin.
Type 2: This type is a result of the body not producing adequate levels of insulin, or the body’s cells developing resistance to insulin. This is the most common type of diabetes, and around 90% of those diagnosed fall into this category.
The signs and symptoms of diabetes
The signs and symptoms of type 1 and type 2 diabetes are the same. If you notice any of the following in yourself or in someone you know, you should visit a GP.
- Frequent visits to the toilet, especially during the night
- Feeling extremely thirsty
- Unexplained weight loss
- Thrush or genital itching
- Slow healing wounds
- Blurry vision
These symptoms are caused by excess glucose in the blood which isn’t being used to create energy. The body will try to flush the glucose away via the urine. This can lead to feelings of thirst and frequent visits to the toilet. High levels of glucose in your urine can provide the ideal conditions for bacteria to breed, which can lead to thrush. High levels of glucose can also damage the blood vessels in your eyes which will affect your vision. If you ignore these symptoms, it could lead to very serious health problems later in life.
Type 1 diabetes can lead to diabetic ketoacidosis, which, in acute cases, can result in coma and death.
Type 2 diabetes tends to develop later in life at a much slower pace. Because it develops slowly, many people do not realise they are unwell. If left untreated, type 2 diabetes can cause damage to the major organs of the body such as the heart, kidneys, and nerves.
Diabetes cannot be cured, but it can be managed. However, to properly manage the condition, you will need the support of medical professionals who can monitor your progress and offer medication and advice.
The next steps
If you display any combination of the above symptoms, you should book an appointment with your doctor today. Having these symptoms doesn’t mean that you definitely have diabetes, as other medical conditions could cause them. However, the sooner you are assessed, the sooner you can begin treatment. If you do have diabetes, the earlier you are diagnosed, the better your treatment outcome will be.
Your doctor will perform a blood test to establish if you have diabetes. If the test confirms that you do, the doctor may refer you to a specialist clinic for further assessments and treatment. Your GP will assess your weight and diet before recommending changes you can make to your lifestyle which will help you to manage the condition. You may also be given medications which will help to regulate your blood glucose levels.
If you are worried that you or someone you know may have diabetes, contact your GP today.
Type 2 diabetes is linked to weight, with over 90 percent of those who have received a recent diagnosis of the disease being overweight. If you have been diagnosed with type 2 diabetes, losing excess weight could help you to manage the condition and could improve the quality of your life. Studies have found that a person who is living with type 2 diabetes can reduce their insulin resistance by losing as little as 7 percent of their body weight. Below is a guide to some steps you can take on your weight loss journey.
The first thing you will need to do is to establish your Body Mass Index (BMI). The BMI is a medical tool which assesses your body fat in relation to your height and weight. To calculate your BMI you simply need to enter some basic body measurements into a BMI calculator. Once you have established your BMI, you can speak with your GP or diabetes nurse about any support you may need to reach a healthy BMI.
Change Your Diet and How You Eat
The food and drink which you consume can have a dramatic impact on your blood sugar levels and on your weight. If you are planning to lose weight, you should eat a diet which contains high levels of fruit and veg, lean meat, whole grains, and nuts. You should avoid foods which contain high levels of fat or sugar. As well as thinking about what you are eating, you should also think about how you eat. By eating slowly and using smaller plates, you can help to regulate the number of calories you consume. If you would like further advice about changing your diet so you can lose weight and manage your diabetes, you should contact a registered dietitian today.
Get Some Exercise
Losing weight isn’t just about changing your diet, it is also about burning calories by being active. You should aim to do around 30 minutes of exercise every day. The form of exercise isn’t important, as long as it gets your heart rate up and your muscles moving. You may wish to sign up at your local gym, take an exercise class, visit your local pool or rent a fitness DVD. Remember to start slowly and build the rate at which you are exercising up gently. You could even start by going for a walk every day. Exercise not only helps you to lose weight, it can also help to boost your energy levels, your mood, and your overall health.
Set Yourself Realistic Goals
Finally, it will be difficult to measure your progress if you don’t set yourself goals. When setting goals, you should make sure they are realistic and achievable. Rather than saying you want to lose a stone in a month, you should aim to lose a few pounds a week over a longer period of time. When you achieve your weekly goal, you can reward yourself with a little treat.
If you would like further advice, contact your GP today.
Research has found that if you work shifts, you could face an increased risk of being diagnosed with type 2 diabetes. This means that groups including police officers, factory workers and those that work in the hospitality industry could all be affected.
The study compared people who worked standard office hours with those who worked unsociable shift patterns, and found that working shifts increased the chance of developing type 2 diabetes by 9 percent.
Previous studies have made a link between shift work and increased weight and appetite, which are both risk factors for type 2 diabetes. The study, which was published in Occupational and Environmental Medicine, found that the risk is highest for men who work on a rotating shift pattern; this group was 42 percent more likely to be diagnosed with type 2 diabetes than those that work fixed shift patterns at the same time every day of the week. The research involved carrying out a meta-analysis of 12 previous studies which had involved over 225,000 people, 15,000 of whom had been diagnosed with diabetes.
Previous studies into the impact that working shifts can have on a person’s health found that these workers were more likely to develop digestive problems, heart problems and some cancers. However, this is the first study which has made a link with type 2 diabetes.
Professor Nick Wareham, from the University of Cambridge Medical Research Council Epidemiology Unit, said:
“The meta-analysis provides an insightful summary which covers data from several previously published studies and highlights the link between type 2 diabetes and shift pattern working. The results have found that there appears to be a moderate link between the two, which seems to be stronger in men.”
He also pointed out that the research “cannot exclude the possibility that the results can be explained by other factors which are linked to shift working, such as poor sleep, or increased stress. If it is eventually shown that the shift work itself has a link to type 2 diabetes, then the next step would be to establish which interventions could be performed to reduce the risks to those people who work shifts.”
2.9 million people across the UK have been diagnosed with diabetes, and around 90 percent of these cases are people who have developed type 2. It is also estimated that there could be 850,000 people living with undiagnosed diabetes.
Director of research for Diabetes UK, Dr Alasdair Rankin, said:
“The study, which has combined evidence from previous research clearly suggests that shift workers are at an increased risk of developing type 2 diabetes. While the exact reasons for this are not clear, these findings are significant. If you are engaged in shift work, I would recommend that you complete a diabetes risk assessment either at your local pharmacy or online.”
Once diagnosed, type 2 diabetes can usually be controlled by lifestyle changes, such as altering your diet and taking more exercise. Your GP may also prescribe medication which will help you to control your blood sugar levels. If you have any concerns about your health, visit your GP today.
Since 1996, the number of people diagnosed with diabetes has more than doubled. Diabetes is a condition which occurs when a person’s blood sugar levels are very high. Insulin, a hormone which is produced by the pancreas, controls the blood glucose level. If insufficient insulin is being produced by the pancreas, or the body’s cells develop insulin resistance so that they stop responding to the insulin in the blood, you may find it difficult to regulate your blood sugar levels. If the level of glucose in the blood becomes very high, serious health problems may develop.
Type 2 diabetes can lead to a number of complications such as kidney disease, nerve damage, eye disease and cardiovascular problems. In acute cases, type 2 diabetes can lead to the development of life-threatening conditions.
Research carried out by the Physicians Committee for Responsible Medicine has shown that a vegan diet may help to reduce the chance that you will develop type 2 diabetes. Being overweight is one of the major risk factors for type 2 diabetes. A randomised clinical trial found that overweight people who maintained a vegan diet for 16 weeks showed significant improvements in insulin sensitivity, and the functioning of their beta cells, when compared with the control group. Beta cells are found in the pancreas, and they are responsible for the production and release of insulin into the body.
During the 16 week trial, a vegan diet was also found to improve the natural regulation of blood sugar levels, which helped to reduce the likelihood that a person would develop diabetes. Dr Hana Kahleova, the lead author of the study, who published the results of the research in the journal Nutrients, said that the finding would have “important implications for diabetes prevention.”
While further research will be needed to back up the findings of this trial, the outlook is promising for those who have received a diagnosis of type 2 diabetes, or those who are at risk of developing the condition.
The Vegan Society defines veganism as a lifestyle which aims to avoid any form of exploitation of animals. For people who embrace the vegan lifestyle, this can involve not wearing clothes which are made using fibres or skin from animals, and not eating meat, fish or dairy foods which are made using meat or other animal products. In order to reduce your risk of diabetes, you do not need to follow every tenet of the vegan lifestyle. Instead, you can choose to follow a vegan diet. A vegan diet typically includes muesli, yoghurt, vegetables, fruit, nuts, pasta and rice. It is possible to eat healthily on a vegan diet, and most major supermarkets and many restaurants now cater for vegetarian or vegan customers.
If you are concerned about your health, or if you would like further information about lifestyle changes you can make to reduce the chance that you will develop type 2 diabetes, you should book an appointment with your GP today. Your GP will be able to assess you before offering further advice and treatment.