Is it typical to form ketones whenever BG rises, not just when one is sick or having an obvious pump issue? My new CDE asked me to track ketones randomly and generally readings are normal. But twice now I have experienced mildly elevated ketones (e.g., 1.1 this morning) with a rapid BG rise (from 128 to 160 when my glucose alarm woke me and on up into the low 200s before the IM injection kicked in). Anyway, I just got to wondering if anyone else experienced this. Thanks!
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No, it’s not automatic with rising blood sugars. My son can be HI on his meter and have 0.1 ketones if he has lots of insulin on board. I would say it’s more typical of fasting or maybe being 5 to 6 hours out from the last meal. For instance, if my son skips lunch, then we were to test his ketones around dinner, they’d be around 0.4 or 0.5.
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I’ve only ever monitored my ketones if I’m really sick, or after a dka.
But if I do a random test and it’s beneath 1.0mmol then I don’t worry about it, if it’s above, then I go into sick day management. I do that because I seem to have the ability to go dka at the drop of a hat (lucky me!) so if I don’t get on top of it straight away, then my day is going to get bad.
My levels are currently quite high because I went out for dinner and ate so many carbs and the correction I gave myself, hasn’t quite worked it’s magic yet, so now I’m going to do a ketone test to see if mine is up at all. I hope it’s not!
*edit - no can do. My ketone strips have expired 
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I’d also add that for us, the surprisingly rapid rise at the onset of a meal is a clue that he has ketones. So, if we prebolus and he eats pasta and then rapidly climbs to 400 after being flat at 80 for the whole afternoon – THAT’S when he often has ketones. I think it really is the fact that he’s unfed, and maybe getting a low basal rate during that time because of Loop.
The only other time we see it is when we have that characteristic site failure clue – +9, +9, +9 every five minutes, a steady rise that seems unrelated to food. I think maybe once we have had some mildly elevated ketones with an illness, but that’s it.
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In hindsight, I think this is what happened…again! 
When I changed pumps, I saw what looked like insulin that had back-tracked down the cannula of my Pod. 
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