Measuring Blood Glucose and Ketones

Home blood monitors are screening devices. If you get a questionable result, retest!

Home monitors are only required to be accurate to +/- 20%.

What does this mean to you personally? Example:

1. You test a drop of blood and your meter reads 75 mg/dL.

2. Just out of curiosity, you immediately retest.

3. Your new reading could fall anywhere between 60-90 mg/dL!

Thankfully, most meters are not that erratic.

In the first 2 weeks, test your fasting blood glucose (1st AM).

  • Typically, you will see lower numbers at Day 14 then at Day 1.
  • Use urine ketones strips to detect when you make the shift to ketosis. After that, negative readings are often a “red flag” that you ate or drank a non-keto food in the previous few hours.

In the next two weeks, begin to test at other times as well.

  •  Test blood ketones AND glucose about 2 hours after lunch. (If that’s not convenient, you can test two hours after dinner.)
  • Test at other times of the day as well to learn your range.

Keep a record of your glucose/ketone readings.

  •  Record the day, time, how you felt, when you last ate, and any other info that might affect readings. (Were you stressed or relaxed? Nauseous or feeling great? Shaky or energized?)

WHAT DO YOU DO WITH THIS INFORMATION?
Look trends over time. If you graphed your readings, would you see:

  • A drop in glucose?
  • A rise in ketones?

On several occasions, we took our son’s monitor to the clinic and compared his finger-prick reading with his lab draw. The lab result was usually lower than our monitor. We weren’t testing the monitor’s accuracy. Instead, we were looking for consistency. When we started to get some very unusual readings, we replaced the meter.

In the first few days or weeks of a ketogenic diet, your “numbers” may bounce around as your body adapts to this shift in metabolism. This is normal.

Young people are generally more metabolically flexible. As they ease into ketosis, glucose numbers drop quickly (as low as 55-65 mg/dL) and urine ketone levels may be “large” within a day or two.

As we get older, we ALL develop some degree of insulin resistance that can impact our efforts.
Steroid hormones affect glucose levels:

    • You have some control over “fight or flight” reactions. Once the threat has passed, use relaxation techniques to turn off adrenaline or “shift gears” to a lower stress mode.
    • Cortisol is a “stress hormone” but it also has a key role in maintaining health. It should peak just before waking. High levels stimulate glucose production by the liver. This is normal. Expect higher glucose/lower ketones in the morning!
    • Women often see a rise in glucose numbers associated with the beginning of a menstrual cycle. This is normal but can be enhanced by stress. This is a perfect time for de-stressing.

Steroid drugs (prednisone or dexamethasone) stimulate appetite and raise blood glucose levels. Do not stop taking your medication! Instead, ask your doctor for a safe weaning schedule.

GI challenges, inflammation, a large “tumor load”, treatment side effects, or compromised liver/renal functions can interfere with “compliance” and/or act independently to keep glucose high.

Surgery, radiation and chemo are “injuries” your body responds by raising glucose. Be patient and allow yourself time to recover.

Vigorous exercise can cause a rise in blood glucose. Conversely: gentle or moderate exercise (walking, swimming, moderate “weight training”) lowers blood glucose.

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