Ketones with pump

[Tracy B.]

We have been pumping now for about two months and when he is high we check for ketones and he usually has them. When we were on injections and Logan was high he never had ketones. Anyone else have this problem and why does this happen?

[Amy C.]

My son hasn't had this problem yet, but I can guess the reason your son has ketones.

My understanding is that ketones show that he needs more insulin, as does the high blood sugar. He didn't get the ketones when high on shots because he had enough of the insulin used for background (Lantus, NPH).

Do you do basal tests at all? It sounds to me like the basal rate may be off.

I am not a doctor -- you may wish to ask your endo what is going on.

It is frustrating because I am sure that it takes a lot of insulin to bring down a high with insulin. I know we are to add a lot of insulin when ketones are present.

[Tamara Gamble]

I'm with Amy on this one. Probably basal needs to be adjusted. If the basal is correct, even with a high there shouldn't be any ketones unless there's a kink in the canula.

Tami

[twicker1]

What we were told was that it is easier to develop ketones and go into DKA much faster while on the pump. The reason being that when your not on the pump you are taking a background insulin, like Lantus, that is always in your system. Since we are not using the pump, I don't have any knowledge on how to correct the ketones he is having.

[zimbie45]

HI
the reason it happens on the pump vs injections is because iwht injuections you had 2 insulins going doing 2 diffrent things.. one a fast acting adn one a slow acting... so with injections the slow acting one will take a long time to get ketones if the only issue is with the fast acting insulin.... with the pump you only have fast acting insulinn..... and nothing else... so if there is an issue it will be quick to react with ketones..

[EmmasMom]

Hey Tracy,
If he's having ketones often I agree that the basals may be the problem. It could be an insulin delivery issue as well. Anytime there's not adequate insulin the ketones are going to pop up, and as other have mentioned it happens faster with fast acting insulin because it's out of your system so quickly.
It could be a bad site, or site placement issue.
It could be air bubbles. Air can cause major BG problems and ketones, so I check Emma's line often and purge any I find.
Basically anything that's stopping him from getting enough insulin.

I hope you get it figured out quickly!!!!

[kristy]

We had this same problem with Lexie when she started back in July. We use the comfort detach infusion sets, and at first I think they irritated her site and reduced the insulin absorption. Also, if you do not catch the high fast enough, the ketones come quickly. I really have to be careful to place the site a minimum of 2 inches from the last one, alternating the sides (she uses her rump and hips). I also test a lot. A minimum of 10 times and sometimes up to 15 a day depending on how her numbers look and when we last changed the site.

I also agree with everyone else. the basals could be the culprit. We have to adjust her basals about every 3-4 weeks due to her growing. It makes a lot of work, but the benifits of the pump far outweigh the negatives. Best of luck.

[Tracy B.]

Thank you everyone for you responses. I will call the nurse and find out what to do.:)