ketones...

[CarolK]

I remember my son being ill a couple of years ago, I think he had flu, and I managed it at home and kept his sugars down (his sugars were pretty good actually), then he started complaining of pains in his back, and I tested for ketones and he had a high level, I took him straight to A and E, where after an immensely long wait, a lovely consultant would not let him go home until they had flushed the ketones out! they put him on a drip to do that, so it seems strange to me that they let a toddler go home like that. Happily everything turned out ok for him.

 

[HelenM]

I'm glad he is back to normal.
There is such a thing as DKA at normal glucose levels. It's fairly rare .It is referred to as euglycemic DKA. If you google it you'll it most often tends to get mentioned as in a warning to hospital staff that it can happen. (so I agree with Bev that the staff should have been aware of the possibility.
it seems to be caused initially by starvation ketones. There are some mentions of people getting it who have been vomitting before and also a case where someone had been eating poorly because of depression,
I also remember reading that there are many more cases of DKA at normal levels in the developing world... it wasn't clear whether this was from lack of enough insulin, food or both.

This isn't a good explanation but the best I could find
http://pjms.com.pk/issues/janmar08/article/bc2.html

(its funny, I didn't have to look this up, as it came up in quite another context the other day)

 

[leenevitt]

hmmmm thats what has been happening to me... i mean with my back .. all day today i mean... my sugars were 20 this morning.... may have had a air bubble or something on the pump its working ok now... but mhy back has played up a few times.. lower back.. winded aching feeling... i will def start keytone testing now.... hmmmmm i bet i am not the only one either!!!...

 

[CarolK]

My son when he was dka (yes we have had every conceivable scenario in his 7 years of D) ,became ill very quickly, prob within the space of an hour, he went ot bed feeling fine, then I heard him early the next morning vomiting, I was trying at that stage to be calm, because everyone says I panic! and thought he might just have a tummy bug. But within the space of an hour, he had been sick quite a bit more and was collapsed on the bathroom floor. I tested his ketones and they were high, but I actually hadnt heard of DKA(this was a few years ago), I rang his dsn and she told me to call an ambulance, which I did. It shocked me at how quickly it happened.

 

[CarolK]

sorry , forgot to add, I always make sure he test for ketones, when anything is wrong. You cant be too careful, and the quicker you get treatment the better the outcome.

 

[simone3112]

The only symptom Harrison had was the bad cough, He walk up through the night with a whooopy cough and was crying cause it hurt him. I give him a drink n put him in bed with me. He normally goes next door in the morning to say high (his little routine that he does without fail every morning) when he said he didn't want to go, that's when I rang doc's. Milk makes him really high so I tend to keep away from it if I can in the morning but he wasn't hungry so I give him a glass of milk instead. Im please I've got some people as baffled as me cause the hospital were not intrested at all.

I know i might be a bit of an over anxious mam. i've asked them for vitamin d tests (they don't agree with them) food allergie test - to see if there could actually be a reason for his fluctuating bloods. I no milk makes him high as does orange juice and grapes are like feeding him sugar. They won't confirm whether this is normal or not?? Surely food allergy test are relevant to diabetics. Maybe not. I will get the test done with or without there help.

The last time Harry's meter went off the reading (HI) from about 7 - 9 pm they told me to inject him (he's on pump) and change canula and they rang me every hour until 2am then again at 7 am. Harry hypoed from 2am till 5 am in the 2's 1st hypo he had a cereral bar 14 carbs with 3 glucose tabs. Hospital again said there was no reason why he should have, as the insulin injection would have been out his system. They might not be a reason but he did!! I think that for some reason the insulin was sitting in him and at around 11.30pm around the time he started to come right down. It all released together. App it can't do that. Sorry I've went a bit off the map here!

 

[Northerner]

Grapes and fruit juice send me high very quickly too, and I think that's fairly common. I wonder if, like you say, the insulin had not been absorbed well and then started absorbing in a rush for some reason? I have had this on a couple of occasions where I have got ready for bed, long after my novorapid should have finished, and suddenly my BG starts dropping like a stone.

 

[simone3112]

Grapes and fruit juice send me high very quickly too, and I think that's fairly common. I wonder if, like you say, the insulin had not been absorbed well and then started absorbing in a rush for some reason? I have had this on a couple of occasions where I have got ready for bed, long after my novorapid should have finished, and suddenly my BG starts dropping like a stone.

Does fruit juice keep you high for a long period of time? It seems to with harry even if I double the carb value? It's the same with Milk 100ml he gets 10 carbs sometimes it works other times it doesn't. Grapes are an instant hit n if i carb it 9 x out of 10 he hypo's so we don't have grapes in the house. Fatty foods such as pizza, ice cream, choc etc are no problem for him.

 

[Northerner]

No, juice spikes me straight upbut I don't stay high, so I don't drink it unless hypo because it would be too complicated to try and time the bolus insulin for it. It's one of the things I really miss

 

[bev]

The only symptom Harrison had was the bad cough, He walk up through the night with a whooopy cough and was crying cause it hurt him. I give him a drink n put him in bed with me. He normally goes next door in the morning to say high (his little routine that he does without fail every morning) when he said he didn't want to go, that's when I rang doc's. Milk makes him really high so I tend to keep away from it if I can in the morning but he wasn't hungry so I give him a glass of milk instead. Im please I've got some people as baffled as me cause the hospital were not intrested at all.

I know i might be a bit of an over anxious mam. i've asked them for vitamin d tests (they don't agree with them) food allergie test - to see if there could actually be a reason for his fluctuating bloods. I no milk makes him high as does orange juice and grapes are like feeding him sugar. They won't confirm whether this is normal or not?? Surely food allergy test are relevant to diabetics. Maybe not. I will get the test done with or without there help.

The last time Harry's meter went off the reading (HI) from about 7 - 9 pm they told me to inject him (he's on pump) and change canula and they rang me every hour until 2am then again at 7 am. Harry hypoed from 2am till 5 am in the 2's 1st hypo he had a cereral bar 14 carbs with 3 glucose tabs. Hospital again said there was no reason why he should have, as the insulin injection would have been out his system. They might not be a reason but he did!! I think that for some reason the insulin was sitting in him and at around 11.30pm around the time he started to come right down. It all released together. App it can't do that. Sorry I've went a bit off the map here!

Not wishing to worry you - but have you had H tested for coeliacs? Type 1 children and adults are susceptable to this as it is also an autoimmune problem. Also, on the other list I am on there is a little boy age 6 who has an unusual type of diabetes where his body stores up all the insulin and decides its really funny to let it all go in one go! Poor soul has to be tested every 10 minutes and has DKA twice a week and is blue lighted to hospital on a regular basis. He fluctuates between being HI to LO within 3 minutes and has a full time nurse to care for him through the night. I must stress to you that this is extremely rare though.🙂Bev

 

[simone3112]

He's been checked. When he got diagnosed I mentioned to them that he stunk when he broke wind and did that have anything to do with it. They said no. But the at an appointment the nurse took him to toilet and he pumped and she said it stunk so they checked him came back clear???

 

[bev]

He's been checked. When he got diagnosed I mentioned to them that he stunk when he broke wind and did that have anything to do with it. They said no. But the at an appointment the nurse took him to toilet and he pumped and she said it stunk so they checked him came back clear???

The symptoms can vary from person to person - but smelly wind, stomach ache, unexplained hypo's just after eating and losing weight are just some of them. There are also different tests they can do - I know they can do a biopsy that is more accurate than a blood test. What is his hba1c like? Lots of coeliacs have brilliant hba1c's because they suffer lots of lows and this gives a false feeling that everything is fine.🙂Bev

 

[simone3112]

That's exactly wot the consultant said. Glucose would indicate HBSL but he was normal. He had a glass of milk in morning and a glass of water during the night so his urnie shouldn't have looked as stong? The only thing I can possible think.... He's had some sort of bad stomach during the night although he wasn't sick or anything. It's caused him to dehydrate which inturn has caused high ketones and glucose. The more he drank the clearer his wee. Like I say by the time we got him home he was full of life. Went from lifeless to normal in 4 hours.
Im really annoyed now after everyones comments, the hospital should have done something more. It's horrible when you have no one to bounce off for info. This site is fab I thought it was wrong at the time and spent hours looking on the web for related problems. The only thing i've found like i said before was children under 5 with diabetes can suffer hypos where the liver release glucose and can cause ketones but they would wake up high or the body can think it's starved and can release ketones. That was a what we thought was happening with him a few weeks ago night hypos leading to extreme morning highs. That night it didn't happen he woke up at normal levels and did hypo just under 4 twice but it didn't cause him to hyper. i've done his ketones every morning since and theirs nothing to support this.
I just think that the hospital shouldn't just brush it off like everything else that happens with Harry. The consultant actually said he never met Harriosn but had heard all about him!!!I keep a food and blood diary have also bought a smart pix (nano meters USB link). I know when i've under estimated the carbs or when he's ran round all day. There's no pattern in his BSL at all to top it off the most random thing no body heard of happens to him. Im going to ring the doctors on monday to ask them about the ketones stick (date). I will rule out the possible causes.