Keytones in the morning

[Lucy's mummy]

Hi. My 4 year old was diagnosed with T1 last April, and in the 9 months that have passed we have been fortunate that she hasnt really been unwell with colds, viruses etc.
However, this week she has come down with a really bad cold and temperature and as a result her BG is all over the place!
She is still in the honeymoon phase and only has one injection of 12 units of Insulutard in the morning before breakfast. I have upped the insulin level a bit to try and counter the high BG's, and have treated high BG's before mealtimes with novorapid when needed but i'm really worried that she has been waking up with moderate (++ to +++) keytones in her urine for the last 3 mornings. The keytones have gone by lunchtime each day. Are the keytones caused by her cold (her temperature has spiked in the night - could this be a reason?). I've not really experienced dealing with keytones yet and i'm worried and confused as to whether this is normal when they are ill, or could it be something else? Her BG's have been higher in the morning but not alarmingly so and if she wasnt ill, i wouldnt have been prompted to test for keytones in the morning.

I've tried calling her diabetic consultant and the diabeteic nurse but they are both off on leave for half term!!

Any advice or thoughts, as i'm starting to go a bit crazy with it all!

 

[hkerins]

Well my little girl I say little she is big now has had keytones from time to time, each time we have had we have phoned the hospital and they have taken her in for observation! The honeymoon period is worse because you really don't know what to do its all trial and error! Hope she's ok! X


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[jayne15]

Do you check her ketones on her blood monitor? the urine sample will be a liitle out of time on whats really happening in her body. the ketones may not be diabetes related My non diabetic child suffers frequently with ketones and when I have checked her BM it has been as low as 2- we have been advised these are starvation ketones ( shes not a great eater) they are only ever found in the morning and we try and make sure she has a carbohydrate snack before bed to prevent this. She particularly has high levels 4 + when she isnt well and off her food. my diabetic child only tends to get ketones if she is above 15 and then its usually a very small amount and not at a dangerous level. is she off her food and drinking enough? I would recommend you get her checked out but try the night time snack before bed to see if this remedies the situation.

 

[jayne15]

I wanted to add that if your blood monitor does check them we have been advised we only need to seek medical assistance if above 1. and anything above 2 is considered to be a real cause for concern.

 

[Lucy's mummy]

She always has a starchy snack and a glass of milk with added cornflour at 19.30, her bedtime as we normally struggle to keep her levels up overnight (she had a hypo fit in the early hours in November - most frightening experience of my life!). Perhaps she doesnt need this much at the moment, whilst she is ill and running a bit higher? Or does she need more if they are starvation ketones??
I dont have a blood ketone meter, only the ketostix for her urine. I think the first couple of tests of the day are telling me whats happened overnight and these are the ones that are showing moderate ketones (mid purple colour) and then once she's up and about and had her insulin for the day and lots of fluids, these are getting flushed out and by lunchtime the ketone readings are nil.
Assuming we have another repeat in the morning, I will ring the hospital to get advice. Another sleepless night.......its always such a worry to make sure you are doing the right thing, isn't it. Thanks for your replies x

 

[jayne15]

good luck lucys mummy, it is so complicated somtimes feel like i need a medical phd ! let us know what happens x

 

[carb-counting-mum]

We're having exactly the same. Daughter in honeymoon period, first time she has been ill. She has mild ketones (under 0.8) only during night/before breakfast. They always go after her breakfast. I have also been told these are 'starvation' ketones. Illness makes your body work hard and you need energy, but because you don't eat during the night, you develop starvation ketones. That's how it's been explained to me anyway. Have been told starvation ketones are nothing to get too worried about.

I would ask about a ketone meter. We have the Freestyle optium combines glucose/ketone meter. So easy to use. Much more convenient to use, especially at night. I believe they are more accurate too (you see in real time what the level is).
I'm with you on the sleepless nights! I am shattered a week in, luckily she is getting better now (temperature gone), no more ketones at breakfast, but sugars still high (even with extra insulin).

x

 

[Lucy's mummy]

Well...finally no ketones this morning, hurray! Lucy has definitely been a bit brighter today and no high temps, although we are still running high BG's even with the extra insulin but hopefully this will settle down before she goes back to school next week!

Thanks for all your advice. I'm definitely going to seek out a blood ketone meter. Is this something i should request from her team or did you buy them yourselves??

Its the first time i've posted on here and will certainly do it again. Everytime I read a post from a newly diagnosed parent, it makes me cry, bringing all the terror of the shock of being diagnosed back again. I don't think i've got over the shock even now, 9 months on! (It didnt help that i was 9 months pregnant when Lucy was diagnosed!). Things are much easier now, and Lucy has been amazing, I'm so proud of my little girl. But it doesnt seem to take a lot before i'm back to a gibbering wreck when something throws it all out!!
So lovely to know there are others out there to talk to. Only other diabeteic parents can really understand what we go through xx

 

[jayne15]

Hi Lucys Mum I am glad your little girls is feeling better, we were given the freestyle from the hospital and it really is fab, I have never needed to check Megs ketones with a urine stick. ( I use the sticks for my other non diabetic little girl !) it flashes when there are possible ketones present and then you just put a different ketone strip in and squeeze a little more blood out and then gives you the level and then you just take it from there in terms of management- no trips to the hospital unless of course its a high level. ask your team otherwise contact the company I've heard they give them for free as they make their money from the strips.

I agree the forum is great, its good to have the support from other parents who are going through the same or similar.

Take care Jayne