High bg, trace ketones, acting fine..possibly the start of illness?

Bg was normal this morning. 94. Bolused for breakfast. Off to school.

10Am bg 372 trace ketones. Gave correction.
10:40 bg 342 still trace ketones. Bolus for snack.

They will call again in about 20 minutes.

Could she be coming down with something? Unexplained highs, makes no sense to me. Should I bring her home?

 

If she feels fine, I see no reason to bring her home.

I'd say about 50% of our highs are "unexplained." Most of them are obviously due to inadequate basal, but I have no clue most of the time why basal needs increased suddenly.

Trace ketones don't concern me. If BG isn't down at the next check, I'd have the nurse do an increased temp basal along with the correction. (ETA: You're not going to know anything in 20 minutes. BG will probably be higher because of the snack.)

 

I don't worry about trace ketones either.

My son stays home when he is vomiting or has a fever -- same as other kids.

 

I figured bg would go up, it did but not much. 355. But ketones are now small. She is eating lunch and going outside, which normally brings her in range on normal days with all the activity. Figures on MY day off from work this happens lol

 

When was the last set change? Sounds to me like either a bug or a site going bad/not absorbing properly any more. My son's sites sometimes go from fine to bad pretty quickly on the 3rd day.

 

Bubbles in the line, causing an underdose of basal? Or just a bit of a kink? Or hitting a "bad" spot (little scarred, etc.)?

Selah often gets higher bg when everyone else in the house is sick, so it sure could be an illness, but it may never actually become symptomatic. I think basal glucose increases when the body is facing a viral assault even if the body wipes it out before it has a chance to get anywhere!

How's she feel? That would be the main determinant for me.

 

Sounds like a site issue to me... we have ketones show up quickly like that when insulin isn't delivering/absorbing as it should. Also, we have plenty of times we have high numbers without ketones so when ketones show up I automatically assume there is a lack of insulin event happening rather than a normal reason for high w/out ketones like miscalculating carbs. But you are also correct in thinking this could be a sign of illness coming on - either way, for now just follow the guidelines for what to do to when you have ketones and the reason will come to light pretty soon

What I would do:
Any immediate correction needed would be given w/a shot instead of the pump... Full site change to be done asap push fluids then standby and monitor to be sure everything clears.

If you are checking urine ketones, remember those results lag behind at least a couple of hours than what is happening "live" in the bloodstream. We use the urine sticks too, but pull out the precision meter and blood ketone strips when ketones appear and rely on those numbers (instead of the urine test) to be sure ketones are declining instead of climbing....

 

40min really isn't a lot of time to see bg coming down, as for the ketones, if they are urine ketones they are hours old, so in 40min you definitely won't see a difference.. and if she ate lunch and you checked after that (the 355) unless she ate a carbless lunch of course it'll go up. If she's still on the higher side when she gets home, I'd change the site... A site that is working fine and then all of a sudden there are whacky highs has gone bad in some way. An airbubble could have snuck in there, or the absorbtion could be down, or the cannula could have gotten bent.

Hope she comes down soon.