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large ketones in school

Discussion in 'Parents of Children with Type 1' started by amazingrace, Nov 1, 2010.

  1. amazingrace

    amazingrace New Member

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    Hi! I'm a caregiver in the school setting and I have a question about ketones.

    How often does your child have ketones during school? Large ketones? How does the school handle this?

    Should I be very concerned when this happens at school?

    Thanks so much!
     
  2. Flutterby

    Flutterby Approved members

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    It depends on the child, when and why ketones are being tested, and how they are being tested, what 'large' is.
     
  3. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    Just so we know, are you using ketostix or a blood ketone meter?
     
  4. amazingrace

    amazingrace New Member

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    Ketostix...
    And while I'd love to give more details, I feel I need to protect the child's information, so any general info. you all could give about what ketones mean, how they affect child (young elementary grade), what to watch out for, could playing outside with moderate ketones be dangerous, etc. would be greatly appreciated! Thanks!
     
  5. hdm42

    hdm42 Approved members

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    the problem with ketostix is that they are hours behind. The ketones could be gone by the time you get the reading.
     
  6. pianoplayer4

    pianoplayer4 Approved members

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    ketones develop when a person does not get enough insulin,is this child on shots or an insulin pump? if the child develops ketones at school you should call his/her parents. thank you for being so involved in your students lives, many children are not so lucky to have a teacher like you:)
     
  7. Amy C.

    Amy C. Approved members

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    Ketones generally means the child does not have (or at least a few hours ago) enough insulin and is not regarded as a good thing. If the blood sugar is high along with this, more insulin is generally needed.

    I would contact the parent for further instructions.

    Having large ketones should be a rare event.
     
  8. joan

    joan Approved members

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    As a caregiver in a school setting, when my son was younger you would only be testing his ketones if his blood sugar was >300. If he had large ketones and high blood sugar it would mean his body is breaking down fat for energy because he had insufficient insulin in his system. If that was the case I was to be called and more insulin would be given. in a situation of high blood glucose and high ketones exercise is not recommended because the body will only burn more fat for energy creating more ketones.
     
  9. Flutterby

    Flutterby Approved members

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    Are you testing in regards to high blood sugar? or are you testing in the am? Like the others have said, urine ketones are hours behind.. if its in the am, then it could be simple starvation ketones (the body produces ketones when its hungry) overnights can cause this.

    Is this a newly diagnosed child?

    to answer your question, it really depends on WHY there are moderate ketones while playing outside, if its because of high bg, then yes, it could be a problem.. is this child pumping? If so, it could mean there is something wrong with the site, and playing outside with large ketones and a site problem can become a huge and dangerous issue quickly.
     
  10. Brenda

    Brenda Junior Member

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    In a person with type 1, large ketones mean insufficient insulin, which can happen for a variety of reasons, including skipping insulin, not dosing enough for the food(s) eaten, pump malfunction, illness, etc. Large ketones in the urine are ketones that could have been there up to about 8 hours earlier. If a child were to have large ketones, he could develop nausea/vomiting/DKA, which can lead to death if not treated properly.

    So, if a child has ketones, the parent(s)/caregiver should be notified ASAP because the child needs more insulin. If this occurs at school, after you contact the caregiver, if you can, push water. If you have insulin for the child, consult the caregiver or diabetes team about the dosing. If the child is nauseous/lethargic/large ketones, you might even want to consider calling 911, esp. if the caregiver cannot get to the school in a timely manner.

    See our web page on Hyperglycemia and Ketone testing at http://www.childrenwithdiabetes.com/d_0n_030.htm

    Ketones should NOT be a common occurrence.
     
  11. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    This is similar to the plan we have in place.

    Ideally, there should be specific provisions in the child's health care plan for school that indicate when ketone testing should take place and what actions should follow depending up on the test result and the blood sugar.

    Judging from your post, I'm assuming that such instructions have not been made clear?
     
  12. StillMamamia

    StillMamamia Approved members

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    Not sure if you mentioned, but is the child on an insulin pump? Sometimes there can be occlusions and insulin doesn't go through and BGLs go up and ketones appear.
    I would talk to the parents about this and what to do in such situations.
    If on a pump, then the infusion set needs to be changed and a shot given to help out.
     
  13. Gaia

    Gaia Approved members

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    We've only had ketones a handful of times thank god but I didnt like the ketostix. I didnt understand the point of treating something that was there hours ago but not now. I prefer the ketone meter because its more up to date. We are supposed to test if he has continued highs that wont come down, illness or above a certain number. Ketones 1.5 or above we call the dr. ; 3.0 or above we head straight to the ER. Thankfully that has happened once - last month, the day after Joeys court date, he called me at work @11am to tell me that his bg was 425 and ketones were 5.1 :eek: I BOLTED out of there believe me. Took 2 seperate trips over 2 days to the ER w/ insulin, fluids and potassium to get them down and gone. Hope that never happens again!

    If testing this childs bg is part of your day, you may want to ask if the parents can put a ketone meter in her bag just in case. It would certainly give you more up to date information, in my opinion. Also ask for clearer instructions on what to do or not to do when bg is above a certain number - e.g. test for ketones, extra fluids, no physical activity ect.
     

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