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Medical Forum / Diseases and Disorders / Diabetes / January 2006Almost OT: Urinalisis and Ketones
Hello group- I'm back for a bit. :) Last Friday I came down with a raging UTI. Actually, it was four days after I'd finished anti-biotics for a UTI, so it had come back worse than ever. Some of the lab results confuse me. I"ve been to many sites that explain lab results, but none can help me be specific to my situation, as there are no standard reference ranges. (according to the material I've read today) The reason I'm asking here, is it is the Ketone results that perplex me. I am in the best control I could dream of. My numbers are all in the "normal" ranges now. My normal FBG is 99. :) I've come very far since diagnosed in 2-2004. The results read: Component: Ketones, UA Value (result): 50mg% Flag: A (meaning abnormal) Range: Negative (or none) I did not find that an infection could cause ketones in the urine. The only thing I could come up with to explain this is that I hadn't eaten in quite a while--mainly because the infection came on so fast, I had to just go to the doctor. Is the % sign a typo? What does it mean? Other findings, just in case it is useful: Hemoglobin, UR, QL, PH, UA; LARGE (Abnormal) (reference is NEGATIVE) Protein, UA: 100 mg% (Abnormal) (reference is NEGATiVE) Leukocyte Esterase, UA: LARGE (Abnormal) (reference is NEGATIVE) Here's the good part. ;) WBC, Urine: Value: 25-50, Flag: (abnormal) (reference 0-5/HPF) RBC, Urine: Value >100, Flag (abnormal) (reference 0-5/HPF) Yes, it is a really bad infection. I'm taking Cipro for 10 days, not the usual 7 days. Thanks for any insight anyone has. TIA, Nancy :) > Hello group- > [quoted text clipped - 42 lines] > TIA, > Nancy :) Nancy, If you are eating a low carb diet--as defined as under 100 grams of carbohydrate a day, you may have ketones in your urine. As long as this occurs along with normal blood sugars, this is usually not a problem. When your blood sugar is high, like, say, over 300 mg/dl and you have ketones in your urine, there is a problem. Not eating for a while could conceivably put you into a fasting state, and that too will generate ketones. I'm not sure what the % means, but the lab tests consider any ketones abnormal, because they assume everyone is eating their 300 grams of carb a day. --Jenny http://www.geocities.com/lottadata4u Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > If you are eating a low carb diet--as defined as under 100 grams of > carbohydrate a day, you may have ketones in your urine. As long as this [quoted text clipped - 3 lines] > abnormal, because they assume everyone is eating their 300 grams of carb a > day. There's a *lot* of territory between 100 & 300 grams! bj >> Hello group- >> [quoted text clipped - 60 lines] > >--Jenny Jenny is partially correct. she is wrong in thinking that ketones only with a high BG of say 300+ is dangerous. A type 1, not sure about a type 2, can easily go into full blown dangerous DKA with a near normal BG and an infection. However you are not describing any signs of DKA. you should go back to your doc and tell him/her that you want that 50mg% explained to you. And if the doc doesn't know that you want the doc to look it up and get back to you with the correct answer. one thing you could do is to check you ketones with the ketodiastix from any pharmacy. They are not expensive. Trace amounts of ketones, especially in a low carb diet are nothing to worry about. moderate to high readings need to be looked into by your doc.  SignatureMâck©® Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o o) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." Jesus never hated anyone. >However you are not describing any signs of DKA. you should go back >to your doc and tell him/her that you want that 50mg% explained to >you. And if the doc doesn't know that you want the doc to look it up >and get back to you with the correct answer. I intend to. I'm just too busy this week. I have a new doctor and so far he is wonderful! When I whined about something fairly normal for a 50 yr old woman, he said, Oh, you are still 25, see your chart! LOL He's a sweetheart. I can email my doctor questions like this. If he doesn't know the answer, I can call the lab directly. >one thing you could do is to check you ketones with the ketodiastix >from any pharmacy. They are not expensive. Trace amounts of ketones, >especially in a low carb diet are nothing to worry about. moderate to >high readings need to be looked into by your doc. Chit! And I have the strips sitting on a shelf above the toilet. I just have to use them! What is the best time of day for this? Morning? Thank you Mack and everyone. I knew this was the place to ask such a question. :) Nancy :) >>However you are not describing any signs of DKA. you should go back >>to your doc and tell him/her that you want that 50mg% explained to [quoted text clipped - 18 lines] >:) >Nancy :) any time of the day. for a fairly accurate reading I was told to void my bladder, then drink some water and test the next time I could go. This way you are not getting readings based on what's been sitting in your bladder until the urge to urinate hits you. SignatureMâck©® Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o o) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." Jesus never hated anyone. >any time of the day. for a fairly accurate reading I was told to void >my bladder, then drink some water and test the next time I could go. >This way you are not getting readings based on what's been sitting in >your bladder until the urge to urinate hits you. Thanks for the tip. I just took the last anti-biotic today. So, I'll test tomorrow, to ensure I'm cured! :) Nancy :) >If you are eating a low carb diet--as defined as under 100 grams of >carbohydrate a day, you may have ketones in your urine. As long as this [quoted text clipped - 5 lines] >Not eating for a while could conceivably put you into a fasting state, >and that too will generate ketones. I should have mentioned that I'm not on a low carbohydrate diet. Until the Holidays I avoided simple carbohydrates, but did not count my carbs. I've eaten way too many carbohydrates over the Holidays, but that is getting back to normal now. :) I believe I'm only eating about 1,000 calories/day right now--which is up from 825 a year ago this time. So, slowly but surely I'm gaining a bit back and eating a bit more. :) I'm also a pre-diabetic for now. I suspect the readings are from a lack of eating and a raging infection. Thank you so much, Nancy :) > Hello group- > [quoted text clipped - 42 lines] > TIA, > Nancy :) The term "mg%" is just another way of saying mg/dL, the same way we measure BG. It is a % weight/volume measure, pronounced "milligram percent". Leukocyte Esterase is a test for an enzyme that indicates leukocytes (white blood cells) in the urine. This is a definitive test for a UTI when there is no indication of elevated WBCs in the urine. Of course, you have both WBCs and RBCs in your urine. You also have blood (from the hemoglobin test) and are spilling protein in your urine, meaning that the filters which normally prevent protein from escaping in urine are inflammed and leaking protein. Ketones are a byproduct of catabolizing fat in the Kreb's Cycle. The most likely cause is that you hadn't eaten enough carbs in the recent past, and your body had switched to burning fat. This should not be a problem for a Type-2. Everything points to a nasty UTI. Drinking lots of fluids should help, and once you get rid of the infection, your BG and other important diabetic measurements should return to normal. Jim >> Hello group- >> [quoted text clipped - 45 lines] >The term "mg%" is just another way of saying mg/dL, the same way we >measure BG. It is a % weight/volume measure, pronounced "milligram percent". AH! That's easy to understand. :) >Leukocyte Esterase is a test for an enzyme that indicates leukocytes >(white blood cells) in the urine. This is a definitive test for a UTI [quoted text clipped - 3 lines] >the filters which normally prevent protein from escaping in urine are >inflammed and leaking protein. What a mess and it all happened within one hour! Hopefully the Cipro will clear it all up. :) >Ketones are a byproduct of catabolizing fat in the Kreb's Cycle. The >most likely cause is that you hadn't eaten enough carbs in the recent >past, and your body had switched to burning fat. This should not be a >problem for a Type-2. I stopped gathering information about Ketones, because I'm type 2 and it appeared it didn't apply to me. But, I bought the strips, because to me diabetes is a science experiment, so why not test everything possible. ;) What you say explains one other thing. One theory of Fibromyalgia is that we have a broken Kreb's Cycle. This is why I started taking alpha lipoic acid long before I ever had a clue I was pre-diabetic. I don't have much fat to burn these days. My weight concern is loosing too much, not gaining weight. In any case, if Ketones aren't being processed properly, it could affect my Fibromyalgia by making me even more sore and can put me into a flare. I'm in a flare right now. Icky. If you are reading, what do Julie Bove and Evelyn think about this? The people with diabetes on AMF (fibro group) do not seem to be open to this type of discussion, or maybe they just don't have enough information to discuss it? Another note: I've been taking the time released form of alpha lipoic acid for the last year. I do believe that it is lowering my bg numbers. At least it is helping with my control. I did not start taking the time released form for this reason, so I'm fairly certain this is an accurate conclusion. >Everything points to a nasty UTI. Drinking lots of fluids should help, >and once you get rid of the infection, your BG and other important >diabetic measurements should return to normal. Yup. I'll do some testing starting tomorrow. I find it pointless for ME to test under the current circumstances. It just gets me all worked up. I think there is a live spring under my couch! LOL I can't believe how much I'm drinking. And I'm taking cranberry pills, rather than the juice. I'm going shopping with Mom today--she gave me a shopping spree for Christmas and today is pay off. :D I'm going to drive her nuts going potty all the time. <eg> Nancy :) To prevent further UTI's use Cranberry extract. It's well known to help prevent them. It's cheap, natural, and has no bad side effects. 73 Gary > To prevent further UTI's use Cranberry extract. It's well known to > help prevent them. > It's cheap, natural, and has no bad side effects. And drink lots of water, pee straight after sex, wipe from front to back after using the toilet (for women) and don't have bubble baths... UTI's are so easy to catch and so easy to prevent (most of the time). It used to be called Honeymoon cystitis - i.e. women often get them when they have just got married (or these days after more sex than usual etc). A doctor told me all this advice more than 35 years ago and I have never forgotten it ;) I strongly urge anyone who thinks they have one, to start straight away on lots of water with urinary alkaliser (can get them from the pharmacy in sachets - keep them ready) and go the same day to the doc for antibiotics. Kidney infection is not the best way to go after an ignored "bladder" infection. In other words, don't treat one at home. A persistent one may need to be tested further to get the exact bacteria type. >And drink lots of water, pee straight after sex, wipe from >front to back after using the toilet (for women) and don't [quoted text clipped - 11 lines] >words, don't treat one at home. A persistent one may need to >be tested further to get the exact bacteria type. Hi Ozgirl! You haven't said anything I didn't know, but it's been a very long time and I appreciate the reminders. :) I think the sex thing may be part of the problem. But, the fix makes sex not as fun. :( Actually, I had just finished a course of sulfa (3 days) for a UTI. About 4 days later (last Friday), it came back. I felt fine, almost totally well. I took a shower and had that urge that you can't ignore. I peed out straight bright red blood with clots. ACK! I called the doc's office at 1 PM and I was seen by 1:50 PM. My HMO is very good when the problem is this urgent. I was pretty lucky, the infection had not spread to my kidneys. :) But, my experience just demonstrates that Ozgirl is right on. At the least hint of a UTI, call the doctor. I did not wait even one minute and I still had a nasty infection raging. Nancy :) >To prevent further UTI's use Cranberry extract. It's well known to >help prevent them. >It's cheap, natural, and has no bad side effects. >73 Gary I do take cranberry pills. I don't remember being recommended the extract. I respect the advice of my local health food store--so I just did what they advised. I'll go back and ask them which would be best for me. :) The UTI thing is new to me. I've had 4 in the last year (3 mild) and none for almost 20 years prior. There are a number of things that might have led to this one. It's just a matter of figuring details out. UTI's are not my biggest problem right now. There were findings on my lung x-rays and that is what I want to pursue right now. The scary thing is that the apparently more serious finding has nothing to do with smoking at all. We think we know what caused it (building fires and scooping cat litter), but have not done a formal investigation yet. In the meantime, DH scoops and I use a mask to tend fire. Thanks for the advice. I'll check out the extract. Nancy :) |
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