Argyle 10/14 - now ketones

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jackie

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Hi -

-5.0 breakfast, 75 mL fluids
AMPS 460, shot 0.2
+2.5 417
+4.75 320
+4 ketones on breath, 25 mL fluids
+6.25 332, shot 0.1, 'trace' ketones in urine.

I went ahead and gave her a little bit of insulin because her BG was pretty much the same as earlier. She has been eating pretty well and just had another good snack. Unfortunately, I have to go out for a couple of hours.

Did I cut down her insulin too fast?
 
Don't second guess yourself. I do not understand her insulin needs at all. Those are high numbers for that tiny dose, but upping them would take some finessing. I keep thinking something else is going on. Once you got your meter set, I was going to suggest an increase.

Glad she is getting fluids and eating well.

Is someone going to be around to keep an eye on her?
 
Hi -
I'm back and not leaving anymore this evening. Argyle just had another good snack and had another 'trace' reading on a Ketostick. She seems ok - not hanging her head like she does when she feels really lousy. I'll get a BG number in ~45 minutes, which will be +3 from the little dose I gave her this evening.
 
Hi -

PMPS 332, shot 0.1U
+3.25 335

She's holding steady - just had another good snack.

I'll be around all weekend, so it'd be great to work on her dose. Thanks for your help!
 
As I understand it, ketones are caused by too little insulin combined with another factor like not eating enough, or infection. I don't know the history, but any time you are seeing ketones, I would consider a dose increase. I think the TID you are doing is a great idea. If it were me, I would be going for green nadirs as long as you can get there without super-steep drops.
 
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