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Link between high temperatures and ketones?

Discussion in 'Parents of Children with Type 1' started by Lize, Nov 14, 2011.

  1. Lize

    Lize Approved members

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    Last week we had a heat wave in our province. On Monday morning my DD woke at 3am feeling nauseous. Put the fan on her - BG was in range. At 7am she vomited and we tested ketones. 0.4. By 9am ketones was 0.9. Bg still not very high - 8.6. I took her to her Endo and he did a blood test to see if she was in DKA. Came back negative. Gave clear juices with insulin and by 17h00 ketones were gone. She felt weak and sleepy for the next 36 hours and after that she was fine.

    Can there be a link between very high temperatures and ketones? This was all just so weird!
     
  2. StillMamamia

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    No, there is no link between high temps and ketones that I know of. Since she woke up nauseous and had ketones with in-range BGs, then those were starvation ketones. I would test her more during the night to see if at any time she is going low.

    DKA happens with hyperglycemia and ketones, and a host of other symptoms, if not dealt with urgently. Ketones coupled with in-range or lower BGs is simply ketosis.

    The nausea could certainly be caused by the presence of ketones, but maybe she's also catching a bug.
     
    Last edited: Nov 14, 2011
  3. Lize

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    What are starvation ketones? And is this as dangerous as high bg ketones? Sorry for all the questions but this is the first time since Dx that she had ketones. We were told to test for ketones only if BG is above 13.5 for more than 4 hours!!! That is the main reason why I didn't even considered testing for ketones before she started vomiting.:(
     
  4. StillMamamia

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    Starvation ketones can occur when there is surplus insulin and no carbs to go with it or poor carb absorption. It is common to have some ketones at awakening for some people, which disappear soon after eating carbs. They can also occur during tummy bugs, where the carbs just come out, yet, if not adjusted, the normal insulin becomes too much, kwim?

    The danger/problem is that they can make you lose weight, since the body, not having carbs for energy (or not able to convert them to energy) will turn to fat and burn that instead. Ketones can also cause tummy aches, nausea. I'm talking about ketones with in-range or low BGs here, not with hyperglycemia.

    We usually test for ketones after 2-3x above 250 (around your 13.5, I think), only because our son produces them very easily. Some kids don't produce them as easily or at all, so really a YDMV thing.

    Like I wrote before, try testing her a couple more times overnight besides your normal testing and see what's happening.

    During a heat wave, it may be possible that insulin needs are reduced too, I guess:confused: More insulin sensitive?

    Hope I explained it well.

    PS - forgot to add that ketosis (production of ketones) can happen in people without diabetes too. The danger is going into ketoacidosis (Diabetic ketoacidosis) in which there is a large production of ketones, which changes the blood's pH, and is life-threatening - this is during hyperglycemia with ketoacidosis.
     
    Last edited: Nov 14, 2011
  5. TheFormerLantusFiend

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    Ketones are the waste product when the body burns fat instead of sugar for fuel.
    The body produces ketones anytime it's using .p fat. That could be a time when it can't use sugar because you're not eating much, when it has unusually high energy needs, or when there's no insulin to let it use the sugar.

    Additionally, insulin breaks down ketones.

    Starvation ketones are less worrisome than ketones caused by lack of insulin. DKA, diabetic ketoacidosis, is acidosis (pH level of less than 7.3 where 7.35-7.45 is normal) caused by ketones, with blood sugar over 11.5 mmol/l. Almost always, this is caused by a lack of insulin.
    However, there are other kinds of ketoacidosis (diabetic ketoacidosis is the most common type, followed by alcoholic ketoacidosis, with ketoacidosis from other causes accounting for well under a percent of cases) and diabetics are more likely to develop them. I have read a few case reports of ketoacidosis in diabetics developing with normal blood sugar because the person just ate extremely little over a period of days or weeks.

    Anyways, your daughter's body was having a hard time using the food she'd eaten (she was about to throw it up) and it had a high energy need (she was sick) so she developed ketones, but that level of ketones over that amount of time wasn't likely to cause ketoacidosis.
     
  6. Nick Masercola

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    As far as I've read there is no direct correlation between ketones and outside temperature.

    However, generally when a diabetic gets sick and their temperature rises, their BG tends to fluctuate tremendously. So maybe, if the outside temperature was hot enough to actually effect her internally ( which would require her being unable to cool herself in most ways) it could have had an effect, but the chances of that seem pretty slim.
     
  7. MomofSweetOne

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    My daughter ran ketones during 100+ heat last summer with normal BGs. Our CDE said they were caused by heat stress and dehydration. When she went to non-D camp, the nurse requested an air-conditioned cabin for her. The endo that gave the nurse a diabetes brush-up recommended it for that very reason.
     

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