Monday, August 6, 2012

Adventures in peeing

I freely admit that I'm not one of those people who diligently checks for ketones. Frankly, I've never had a problem with them when I didn't have a wicked high blood sugar and I've never been made horribly ill by them, so my treatment is basically bolusing corrections, chugging water, and monitoring my BG through CGM and fingersticks.

However, I've recently been working harder to keep a vial of Ketostix on hand just in case - I've had a few problems with vertigo/extreme dizziness after a night of high blood sugars, and I wanted to see if that's ketone-related. 

Last night, L woke up around 4am for a bottle. I'd had a particularly irritating glucoastery dinnertime - a miscalculation for a carby dinner that resulted in a giant crashing low followed by a huge leap right before bed as my bolus was wearing off and the fatty highs were kicking in. Waking up to a "HIGH" reading on my Dexcom meant I didn't get off that glucoaster, and my finger stick clocked me in at an awful 373. 

The giant blank spots? A new sensor at the beginning and, sadly, I-left-Dex-home-today blank at the end.

I felt atrocious (albeit not dizzy) and figured I'd do a Ketostix before going back to bed to get a baseline reading - verdict: no ketones. When I woke up for the day a few hours later, I was at 244. Still high. So I did another Ketostix. And folks, even though I don't check for ketones regularly, I have been diabetic for more than 18 years. I am well trained to be nervous about peeing on sticks. I know enough to root for zero color changes. But when I did the test this morning, I had a bit of a heart attack. I still wasn't throwing any ketones, but holy hell was I passing sugar. My color change went allllll the way to the right:

I won a nice poop-brown reading from the top chart

The problem with this is I honestly have no earthly idea what that means. (And when was that even added to the sticks?! I've only ever seen the ketone test.) According to their little chart, I was spilling 4 zillion metric tons of sugar into my urine. No ketones, though. So...what? I mean, I was bolusing to bring my blood sugar down. I was drinking tons of water to flush my kidneys and the rest of my body. Does spilling sugar require a different tactic? Is it only a problem if I'm spilling ketones?

I tried googling how to use Ketostix and just got a bunch of results for people doing Atkins and Paleo diets. (How incredibly weird is it to think about people intentionally aiming for something I'm trying my damndest to avoid?) I found very little info about it, but did love this little gem:

It's embarrassing to buy Ketostix?!

I can't seem to find them listed on Bayer's U.S. site, and I no longer have the box. I'm sure this will be a non-issue tonight, as I've gotten my blood sugar down around 120 and am drinking water like it's going out of style. But man. Finding this info shouldn't be so complicated!


  1. Being a diabetic for more than 17 years, my new endo figured out I needed some diabetes-schooling recently; this is what my CDE told us: sugar starts spilling in the urine when BG is around 180 mg/dl; ketones on the other hand appear when there's no drop of insulin in the bloodstream - malfunctioning pump, inefficient insulin - and we should check for ketones when BG is higher than 250 mg/dl. As for the Ketostix, a few years back I saw the ones twice as long and with a whole bunch of tests: sugar, ketones, protein and I-don't-remember-what-else :)

    1. Incredibly helpful! And you're not kidding - I often feel like I could use a "tune-up" for my diabetes info. After so many years, it's easy to become complacent and just do the daily stuff you're used to.

  2. I remember, before blood glucose testing was "fashionable", we had a pee-stick called (I think) Keto-Diastix. It measured both ketones and sugar in the urine. In fact, the only way to test for high blood sugars was by peeing on a stick (or in a cup, then using an eyedropper to put it in a test-tube and perform a mad-scientist chemistry experiment). The color scale, if I recall, went up to 5%, which meant you had sugar in your urine ... it's a way your body tries to get it out of your blood (that's why you pee a lot when high, and that's why you're so thirsty, too).

    If sugar was high and ketones were low, it indicated hyperglycemia. If sugar was low and ketones were high, it indicated hypoglycemia (body burning fat or muscle for energy in the absence of regular food). If both were high, it indicated no insulin/ketoacidosis. Crude, but it worked.

    What you saw on the sick was just a regular ol' high BG. But you already knew that, so I'd say it's nothing to get particularly alarmed over.

  3. I've never seen the two-test sticks before. Interesting.

    My question is why can I get moderate ketones on the blood tests and have negative/trace ketones at the same time using the pee test. Maybe I need a tune-up session too.