What level of ketones is normal?

[Sarah_1_2_3]

Hi,

I'm looking for some advice on ketones. I have a little boy (2 1/2) who has just been diagnosed with glucose intolerance or pre-diabetes as one consultant called it. We are to keep check on him, regularly checking his urine for ketones and a 3montly doc app for full bloods etc. But when i tested his Ketones, using urine strips, it was with my reckoning at 3mmol. When I tested myself and my T1 husband we were at 0.

What is normal level? I'm aware that ketones in urine lag the blood level. Also a bit about ketosis and ketoacidosis. I dont particularly want to check my little ones BS as he doesnt like it after a recent trip to the hosp and a bad experience there. I'm thinking that I will keep a check of his urine over the next day or 2 to see what it ranges at. He is well, although not himself either. He is drinking alot and going to the toilet alot but we were told these are signs of the pre-diabetes. he also eating much more than normal today if that is relevant.

Sarah x

 

[Fujifilm]

My understanding is 0 is normal.

 

[lilibet]

Hi sarah

Ketones are not normal, and especially not if accompanied by high bg
They vary of course but mean only one thing (in people on the diabetic spectrum) and that is there is not enough insulin to help your body function. No diabetic ever wants to see ketones and high bg together. Ever

My meter tells me to check for ketones ONLY after a bg reading of 16.3 so I can hit 13 transiently (thankfully not often) and have no ketones. Urinalysis sticks do lag behind and arent precise enough so PLEASE check his bg. I know he might hate it but you need to do it to get a picture

Now Im not medically trained, or telling you what to do but in my opinion a 2 year old prediabetic child (is there such a thing?) who has peeing, drinking, eating more(hunger?), out of sorts and a T1 dad needs to have his bg checked,and not by a GP in a couple of days time
I am not meaning to alarm you (Honest!) but I think you really do need to test his bg, and if you think it might be related to food then test again in two hours. However, high bg caused by wrong foods doesnt cause persistent ketones as such, so if you test, and its high, then dont wait to see your GP. Better to be safet than sorry

Also, to be blunt, I am T1 and can be a what would be classed 'prediabetic' numbers and be none the wiser, and certainly dont get hunger, thirst, peeing etc so again, you really need to establish what his bg is sitting at

Hope things go ok, let us know how you get on

 

[Sarah_1_2_3]

Hi and thankyou,

I too didnt realise there was such a thing as a pre-diabetic! I thought you either were or weren't but apparently not, esp in children, where there can be what the consultant called a honeymoon phase. Stange if you ask me!

Anyway, I have been watching him carefully over the last few hours and hes been going to the toilet alot and eating and drinking lots. I checked another urine sample and it was at a trace. I did make him drink lots in the hope it would flush it out, as I know thats what my husband had been told to do when he was changeing insulin and had bother with ketones. What does fluctuating levels show? Can it go up and down in a 'normal' person? I'm somewhat confused now!

Sarah

P.s. I didnt check his BG, but might try it when hes asleep.
P.p.s The hospital consultant said to take the BG of a non-diabetic child, even if considered at risk, is 'against his human rights', and should be left to the doc! Needless to say I didnt respond nicely to that answer.

 

[kegstore]

He is drinking alot and going to the toilet alot but we were told these are signs of the pre-diabetes.

These are also some of the signs of full-on diabetes. Your boy may not like having his blood sugar tested, but I think you need to do that test to see what the result comes back with? Better to know now than wait and risk a hospital admission with DKA? Urinalysis is not going to tell you much when compared with a blood drop from a finger, I'm amazed such sticks are still available!

 

[leggott]

Hi Sarah, On reading this and your other posts, I really do think you need to go back to the Dr's asap. As other people have mentioned DKA can be extremely serious, especially is one so young. It shouldn't be your job in monitoring this, but the hospital and I'm shocked at the information/advice you have been given. If I was you, I would perform a finger prick test on him. We use the muti clix lancet on our children, which has a very low setting, so it shouldn't hurt him. Good luck.

 

[lilibet]

Also sarah, on reading back you mentioned pre diabetic in the same terms as honeymoon

Honeymoon period is usually AFTER being dx with diabetes, your pancreas gets a bit of a rest (from it being treated) and then makes some insulin which does reduce need for insulin and in some peeps their requirments are very low which lead some people to think they are 'cured'. They arent. Honeymoon period always ends, time and intensity of this varies, and requirements increase

Glad the little un only has a trace now, drinking loads is the best idea (and of course helps explain the peeing in part) but please have them clarify their diagnosis, or not. My understanding is that pre diabetes is mainly in adults, most likely to end up T2.

Your Docs comment about human rights is ridiculous and if thats who you rely on for medical advice and treatment, then............ If littl un was unwell and needed and operation, they would ask you for CONSENT to operate. So, human rights my pancreas!!

 

[Sarah_1_2_3]

Hi again,

Yes lilibet, i too thought pre-diabetic was in T2 adults showing very near diabetic levels. But my GP backed up what the older consultant said. He calls it glucose intolerance, which he says is a more accepted term by newer qualified docs. He said its not seen everytime with children but he has seen it a few times before. It was then he called it this honeymoon phase, where he said his pancreas is not fully functioning, or more likely that it isnt growing, and when he grows it will become more and more insufficent. Its quite a daunting thought to be honest, esp when they cant even agree on an answer amongst themselves.

When he falls asleep i'm going to do a test as when I asked if he wanted to test his sugar he went mad at the sight of the montior, telling me I was a bad mummy. Dont blame him really, I hate getting it too!

Yes the consultant and the human rights thing was totally off. She even said that my husband shouldn't be doing his insulin and blood check routine infront of the kids! I had a go at her about that one. She surely thinks shes a higher being than us mere mortals.

S x

 

[hanadr]

Sarah, ask for a referral to the diabeic clinic. This needs sorting out ASAP. Your little one deserves better.
I too am not a medic, but it sounds like T1 to me wrapped in flimflam.
Hana

 

[Sarah_1_2_3]

Just a quick update. Did his BG, it was at 9. He did have a lolipop about an hour or so before that too, so could equate for the slighly higher than normal reading. But surely thats ok. Yet another odd ball just to confuse me!
Thanx again guys x

 

[dave howard]

Hi,

I'm looking for some advice on ketones. I have a little boy (2 1/2) who has just been diagnosed with glucose intolerance or pre-diabetes as one consultant called it. We are to keep check on him, regularly checking his urine for ketones and a 3montly doc app for full bloods etc. But when i tested his Ketones, using urine strips, it was with my reckoning at 3mmol. When I tested myself and my T1 husband we were at 0.

What is normal level? I'm aware that ketones in urine lag the blood level. Also a bit about ketosis and ketoacidosis. I dont particularly want to check my little ones BS as he doesnt like it after a recent trip to the hosp and a bad experience there. I'm thinking that I will keep a check of his urine over the next day or 2 to see what it ranges at. He is well, although not himself either. He is drinking alot and going to the toilet alot but we were told these are signs of the pre-diabetes. he also eating much more than normal today if that is relevant.

Sarah x

Sorry to say this Sarah, but to be blunt, not testing his bg levels is rather like sticking your head in the sand and hoping he hasnt got type 1 diabetes. Meanwhile unfortunately, as he has got a positive ketone reading, damage to his body could be already happening

 

[dave howard]

Just a quick update. Did his BG, it was at 9. He did have a lolipop about an hour or so before that too, so could equate for the slighly higher than normal reading. But surely thats ok. Yet another odd ball just to confuse me!
Thanx again guys x

It sounds to me that you are desperate for reasons to not admit that your son may have type 1 diabetes. He needs to see a doctor, and for him to tell you face to face, that serious testing needs to be done. If you don`t sort this out promptly it could lead to complications in such a small child. You have already told us of 3 different symptoms which your son is displaying.I hope you get some answers from your doctor, if need be get a second opinion from a different doctor.

 

[Sid Bonkers]

Hi Dave, I think this question is probably redundant now as it was posted in Jan 2010, I would hope the little lad is well into a routine by now