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Large keytones and won't eat...what should I do?

Discussion in 'Parents of Children with Type 1' started by Mojo's mommy, Dec 2, 2007.

  1. Mojo's mommy

    Mojo's mommy Approved members

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    Courtney has not eaten a bite all day. Nothing I offer her good or bad will she take. Her tummy hurts and she will not put anything in her mouth. I have had her on and off a temp basal all day, her BS is the low end of normal and her keytones are large..

    I am stressed...what should I do???
     
  2. kevin@diabetech.net

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    The best answer w extended duration of large ketones and no comfort for what to do next is always to call your endo/cde asap.
     
  3. Mama Belle

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    1. Go in the other room
    2. Yell your favorite profanity
    3. Take a deep breath, or splash water on your face (your choice)
    4. Call the endo
    5. While waiting for a return call (since we know you'll have to wait) see if you can get her to drink something high sugar that is fun, like a Slurpee or regular Popsicles.
    6. If she won't have it, try bribery.
    7. If she still won't have it, start packing for the ER while continuing to wait for the endo's return call.

    If her BG is low and she refuses to eat, there really isn't much you can do to clear those ketones. The best thing she can do is to eat or drink something with high sugar content so you can give insulin. Even drinking water would be better than nothing, to help flush the ketones. Get as creative as possible with food options. It doesn't matter what she eats as long as it is something with a decent amount of carbs!
     
  4. kevin@diabetech.net

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    PS - no exercise! but do drink lots of non-caffeinated fluids!!! Dehydration is the one thing that seems to put kids over the top quickly w large ketones. Diet sodas are a good option, too, while we're on the bribery kick ;)

    Speaking of bribery, I remember pre-pump days when we had to threaten ice cream sandwiches if my daughter wouldn't eat her dinner carbs (because we had of course already given her the insulin...)

    D is strange stuff, eh?
     
  5. Mojo's mommy

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    Just checked her, her BS is 3.6..( canadian) her blood keytones are 1.8 and Large on a ketostix...

    She is sipping Gatorade, but slowly...she is soooooo stubborn

    Mommy is having a Corona...sipping not sooo slowly

    Calling Endo now..:(
     
  6. Sarah Maddie's Mom

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    sounds like Hunger or "starvation" ketones to me. Anything else that she'd rather drink with sugar in it? Or popcicles, or even just juice?
     
  7. Mama Belle

    Mama Belle Approved members

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    3.6 is not so good. 1.8 is also not so good. BUT ... it could be worse. As long as she is drinking gatorade that's good. keep it going. Caffeine free coke, pepsi, sprite, gingerale (regular, not diet) would be better since it is higher carb. But if all she'll drink is gatorade, then that's better than nothing!

    P.S. The Corona is a great idea!
     
  8. kevin@diabetech.net

    kevin@diabetech.net Approved members

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    Mini-Dose Glucagon

    "The protocol recommended the use of subcutaneous injections of glucagon using insulin syringes at a dose of two 'units' (20 μg) in children 2 years of age or younger, and for older children one unit per year of age up to a maximum of 15 units (150 μg), with an additional doubled dose given if the blood glucose had not increased in 20 min."

    If you have Glucagon at home (and I hope you do) you should discuss the mini-dose glucagon w your endo and if it gets really bad use this info as you see fit.

    It has been clinically proven beneficial and safe but is not widely known although most parents on this board have at least heard of it. A small dose in relation to age/weight can cause the liver to 'tip' just a bit of glycogen into the blood stream vs. the severe dumping of the full emergency dose.
     

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