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Starvation ketones..

Discussion in 'Parents of Children with Type 1' started by Kaylas mom, Feb 13, 2011.

  1. Kaylas mom

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    So if the blood sugar is normal are ketones in a diabetic bad? I am not sure if I am wording that right. Kayla has some bug.. she isn't throwing up but her stomach hurts (maybe from the ketones?) she doesn't want to eat.

    I got her to eat some toast so she could take insulin but currently has large urine ketones.

    Is this bad or normal because she isn't eating??
     
  2. frizzyrazzy

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    has she had appropriate insulin? In the case of an illness any ketones should be taken seriously - especially if she isn't getting her normal amount of insulin. You need to give her more insulin to clear those ketones. IMO starvation ketones rarely get to "large".
     
  3. Kaylas mom

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    I am having her drink some reg sprite so she can get some insulin.
     
  4. Sarah Maddie's Mom

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    Maddie's had some pretty "dark" urine ketone tests after not eating and while maintaining pretty normal bgs.

    My endo has always been pretty relaxed about what we presumed to be starvation ketones, so I have not ever been too stressed and we've never had a bad outcome. Obviously with ketones you want to look at the whole child - is she hydrated, is she just moderately ill, is she able to keep some light food and liquid down, is she not throwing up ... if so, then I personally would not worry too much about starvation ketones. BUT, I would watch her closely for any change and bear in mind that the ketones showing up in urine are old news and difficult to rely on.

    Good luck!
     
  5. Kaylas mom

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    Thanks Sarah. I do know that urine ketones are usually about 2 hours old. Probably even longer because I don't think she is very hydrated. I am going to push fluids and keep an eye on it.
     
  6. Flutterby

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    Make sure she's staying hydrated.. ketones can be dangerous at any time. You are probably seeing a combination of starvation ketones and ketones from the illness. Since her bg's are ok, you know its not from a bad site. Keep having her drink something with sugar in it so you can give insulin and hopefully those ketones will go away. The thing to watch out for is if she starts throwing up with normal to low bg, has ketones and refuses to eat.. Every ER trip for an illness and ketones this has been our situation.
     
  7. JackyH

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    For our last stomach bug the Endo told me not to bother testing for ketones as he would most certainly have them since he wasn't able to eat and they were nothing to worry about. Of course, I just had to test for them and they were the highest we had seen since DX. I still tried to clear them but they are definitely not as serious as high blood sugar ketones - those are the suckers you really have to worry about.
     
  8. ashley_lynden

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    I don't think they are theat big of a deal, but they sure scared the crud out of me. Sloan had huge amounts of starvation ketones after having his tonsils out. The strip would turn the darkest maroon within about 2 seconds of his urine touching it. The pediatricians in the hospital were not concerend at all. I called the on call endo numerous times and he didn't act like it was anything to worry about. (Sloan was getting 0.5 units of lantus in the morning and nothing more since he wasn't eating.) The pediatrician ended up giving him DR through his IV hoping we could bump his blood sugar up high enough to give him more insulin but he never got high enough. Finally after 48 hours of the high ketones they ran labs and everything was fine so we went ahead and went home. He continued to have high ketones for almost a week. He lost lots of weight, but nothing more ever happenend.
     
  9. Kaylas mom

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    Ketones are down to small. :)
     
  10. GaPeach

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    Fantastic!
     
  11. Kaylas mom

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    At one am they were down to trace. She has been sipping reg sprite all night so hopefully she will be feeling better soon. Both her and her brother will be home from school today.
     
  12. selketine

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    William had a similar situation once - throwing up, LOW blood sugar and large ketones.

    Long story short - it is a HIGH bg and ketones that are most dangerous and the ER trip is pretty much in the cards. With a low BG and ketones they may need an i.v. for hydration if they cannot keep fluids down - and the doctor might prescribe something to keep them from throwing up - these ketones can lead to something more serious but generally do not if you can keep giving carbs and insulin.
     
  13. emm142

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    If I don't eat for more than 12 hours, big starvation ketones are pretty normal for me (moderate to large). If I don't eat for a day, the urine strip will turn the darkest purple colour. They don't cause any problem, except that the next time I do eat I need extra insulin compared to what I would normally need for the food, because the insulin is clearing the ketones as well.
     
  14. Kaylas mom

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    We have been battling ketones on and off all day. According to the endo on call, ketones are bad in diabetes regardless if the bs are high or low.
     
  15. Flutterby

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    I would agree.. while 'starvation' ketones aren't as much of an emergency of high bg and ketones, they are still something that you should watch. It means your body doesn't have enough insulin and is using fat for energy. A person with type 1, their body can't process ketones like someone without D.
     
  16. wilf

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    I respectfully disagree with the endo. If that were the case, then all our children would be doomed to be overweight because they could never lose weight.

    Ketones naturally develop when their bodies burn fat for energy due to exercise and/or dieting (they are a by-product of that fat burning process).

    The key is understanding the cause of the ketones. If they are clearly from exercise or reduced caloric intake (and there is no sickness or insulin deficiency involved), then in my books they are not bad. In fact, I would deem them good.. :cwds:
     
  17. abdabs

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    Glad to read this, Wilf. My daughter who may still be honeymooning has had zero insulin needs at night. In fact she sometimes drops. She is on 5u of Levemir daytime. We recently discovered that she is waking up with MOD ketones, though. Presumably due to not having enough residual levemir. I'm sure these are starvation ketones, so do I worry? They go away within a couple of hours after her morning/bkfst bolus. We started giving her carbs before bed so we could give levemir, but an Endo slapped our wrist for that. I'm confused! Our orders were to try 0.5 levemir at night anyway... Despite me telling them that we have done that and she WILL go low.

    Do short-term but daily starvation ketones pose a health risk?
     
  18. mom24grlz

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    Ashleigh went through this after her spinal surgery. For a week following the surgery she had ketones, but her BS were normal. We think her's were due to her not really eating anything and the stress from the surgery. I'd get them down to the negative range and then 2 hours later i'd recheck and they'd be small-moderate ketones. Since her BS was normal whenever she did eat or drink anything I'd increase the amount of bolus she was getting, and that helped to bring them down. Once her pain level was down and she started eating more the ketones went away.
     
  19. DsMom

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    My son's endo is the same. I used to be pretty freaked out and kept trying to give water to my son....just resulting in him throwing it up. But when we started seeing his current endo, he said not to worry about starvation ketones. When he was sick yesterday, I didn't even check his ketones. Today, I did, and they were 0.6..he is still not eating much and his BGs are fine. I am not forcing anything, just encouraging him to drink as he has diarrhea now.

    Don't expect docs in the ER to understand this though. Last year, when my son was vomiting continuously and crying from stomach pain, I brought him to the ER...I was afraid it was more than a stomach bug. He did have large ketones...as expected...but his BGs were good to lowish the entire time we were there. They put him on fluids, which I appreciated and wanted....but were refusing to let us go home later until the ketones were cleared. He was not eating, of course, and they wanted him to keep food down for an hour before he could go home. After the fluids, I knew I could handle him at home, and also knew we might take a day or two to clear the ketones. I did not want him admitted as I got the answers and fluids I needed, and knew how to handle a regular stomach bug and ketones at home. Hours and hours later, he still had the ketones, but I finally convinced them his BGs were fine and they were from not eating. (Even our endo told them that when they called him.) They still insisted he keep food down...so he had something eventually (I forget what), and he kept it down for an hour. As we were leaving, he said his tummy was starting to hurt again...and I was practically running out of the hospital with him in my arms to avoid them seeing him throw up....which he did the minute we stepped in the door of our house (we only live 5 mins from the hospital). That was the last time he did, though, and it could have been avoided had they not forced him to eat.:mad: I felt like I was being held hostage there last time...and am now very hesitant to go back again. (Of course, would have to in an emergency.:()
     

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