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Clearing ketones with carbs?

Discussion in 'Parents of Children with Type 1' started by momofone, Feb 16, 2013.

  1. momofone

    momofone Approved members

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    I know this should be very basic but this is the first illness where we've had ketones. I've managed to keep BG in check after ramping his basal up 75%. He woke up with a fever of 104 and 2.3 ketones. BS at that time was 205 and gave 2 units to correct and for the ketones. A couple hours later, dosed him for his soup, about 13 carbs, plus a little extra. BS now is 95 but ketones are still lingering. Is there a set percentage more that you give with carbs to help clear the ketones? I followed our preventing DKA protocol the first time since he was high but there are no instructions for it BG is normal, or is it still the same x 1.5?
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    How much had he eaten in the past 24-36 hours?
     
  3. Darryl

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    The carbs are not to help clear the ketones, they are so that you can give more insulin (which is what clears the ketones) without going low. Water is also important.
     
  4. Helenmomofsporty13yearold

    Helenmomofsporty13yearold Approved members

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    I have never dealt with this, so I am no expert. My instructions from our endo (9 years ago) were to raise the BG with sugar containing fluids to 10mml (180) then give 10% of TDD. I guess you would subtract any extra you have already given from the 10% figure as that seems like a big correction if BG aren't being spiked up from the illness. I think what you do depends on whether your child can take carbs without vomiting, keeping in mind those ketones can cause nausea and vomiting.

    The articles below don't seem to be suggesting more insulin, just the sugary fluids as they are talking about vomiting, the possible need for less insulin and avoiding dehydration.

    http://www.ispad.org/sites/default/...pad_guidelines_2009_-_sick_day_management.pdf

    http://onlinelibrary.wiley.com/doi/10.1111/j.1399-5448.2009.00581.x/full
     
  5. momofone

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    He's eating normally and is hungry. I don't understand where the fever is coming from because he seems otherwise fine, for the most part, not specifically complaining about anything but no totally himself either. Ketones are down to 1.4. I'm so confused.
     
  6. DavidN

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    It is my understanding that carbs, not insulin, will clear starvation ketones (if that's what they are) which I suspect is why Sarah was asking about eating. There is a nice long thread in the recent archives that discusses this ad nauseum.
     

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