An Adventure with Ketones

This all started with brownies.  Last night, a couple of friends and I made them from scratch.  I've never made brownies before, so I thought it would be fun to try them.  The recipe we used had no nutritional information, so I guessed at the amount of insulin I needed.  I guessed badly, did more insulin when I got home and went to bed, thinking that was that.

This morning, I woke up early and knew something was very, very wrong.  I checked my glucose and sure enough, I was 17.7.  I thought at the time that I was still high from the brownies and immediately did insulin.  Thinking I'd been high for several hours, I did a blood ketone test and sure enough it came out 3.2 (which is very high for ketones - they should be less than 0.6).  I don't know how accurate the test was because I only had expired strips at the time, but they were better than nothing.  So I did a bunch of insulin and thought it should come down.

A little while later I checked my glucose again, hoping it was coming down.  It actually went up to over 21.  That's when I discovered my insulin pump site was barely hanging on; most likely none of that insulin was delivered to my body.

I think what happened was it came loose last night.  I didn't realize it, and so fell asleep; while I was sleeping it came off completely.  That's the only way that what happened makes sense: I obviously got some insulin before going to bed because my glucose did go down a little bit.

Needless to say, everything is back under control now.  I've spent the day drinking diet pop every half hour (for some reason water becomes toxic in my stomach when I have high ketones), and checking both my ketone and glucose levels.  After ensuring I got insulin, (I did an injection immediately after discovering my insulin pump wasn't giving me insulin) and getting some fluids in me, I ran to a pharmacy and replaced the blood ketone strips so I know the later readings were accurate.  Testing everything every 3 hours (and doing larger boluses than my pump recommended), I am fine as of 4pm.  This is the same method which I used a few years ago when I had something similar happen (that's a story for another time).