Charlotte threw up all night and woke up with ketones of 1.7. I gave her extra insulin and a couple hours later they were 0.6. She threw up again, took a shower and then didn't put her pump back on. Her blood sugar has been in the low 200s, high 100s all morning, but I've been checking ketones regularly. When I realized she hadn't had her pump on for about 90 minutes, I checked and they were back up at 1.6. I gave her extra insulin (the books says 10-20% of TDD which is between 13-16 units). I gave her 2 units (preferring to be cautious because she's still not keeping anything down) and an hour later her ketones are 2.1. She had perked up for a while and saying her stomach felt better, even when her ketones were 1.6. Now she's complaining of a headache. How quickly should ketones clear? For Charlotte they typically clear very easily. So I was surprised to see they had gone up an hour after giving her more insulin. I'm about to give her some gatorade in order to give her some more insulin. Just trying to gauge how worried I should be. In almost 6 years with diabetes, we have rarely dealt with ketones.
She hasn't eaten anything since dinner yesterday. I gave her gatorade with 15g CHO about 2 hours ago. Her blood sugar is 150 and her ketones are back down to 0.3. I'm assuming that until she eats (and digests) something, her body is going to keep making ketones. So should I keep giving small extra boluses in the meantime? Her blood sugar is okay. When I posted this originally she had nearly 3 units on board (which is a large bolus for her, especially with nothing in her stomach!) but her blood sugar didn't drop. So I feel comfortable giving her smallish boluses without food. She's currently sleeping. The poor girl was awake most of the night.
I haven't had much experience with large ketones, so I can't add much to this thread except to say I hope you sweet one feels better soon. :cwds:
We had very large ketones the last time my daughter had a stomach virus. We were not able to get rid of them because her BG stayed under 100 and nothing we did could get her up. Ergo, we could not give her insulin. We ended up in the ER. But, it sounds like you are doing a great job and getting them down. .3 is considered almost nothing, so hang in there. She needs insulin and hydration, which you are doing, to keep those ketones down. You are doing great! Stomach bugs are the worst things on earth for our CWD ugh!!!!!
Thank you everyone. Her ketones have stayed down at 0.4 or 0.3 since yesterday. She's eating again but I'm not bolusing for food, only correcting for highs in case she throws up again. In the past, she seems to need very little insulin for several days after a stomach bug like her body isn't digesting her food or something. Now we're on to the 14 month old who has been throwing up non-stop since last night. She's starting to worry me. :frown:
Yeah, definitely need the carbs if she can keep them down. Without the carbs, sickness ketones AND starvation ketones are piling up together!! Good luck!
What I don't understand is how she wasn't low after throwing up, usually for us vomitting and lows come together. What we learnt is never stop the pump it keeps the glucogen in the body and prevents high ketones. Stomach viruses are terrible!!!!!!:frown:
I was told to never stop insulin too. We do a -40%basal with stomach things (although it's only been one time in 4 years and that was only diarrhea). I would get a prescription for the anti nausea medicine that I'm NOT REMEMBERING the name for now. Someone help me out here lol
hello, my son (type 1 diabetic) was in the ER yesterday with high ketones and was vomiting. He was given fluids and zofran and we were released back home. He now has a low-grade fever today that tylonol and motrin won't touch, has a headache and is throwing up again, despite zofran use. His ketones keep going up and down. I gave him his normal lantus this morning and he has kept down a little food. Why is he still vomiting? He has had diabetes almost 4 years now and we've never dealt with vomiting this long before. does anybody know what else we can do?
Sounds like the flu. It's tough, you just have to keep monitoring blood sugars and ketones. Be prepared to go back to emergency if need be.
