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Understanding ketones

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Caris1983

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Parent of person with diabetes
Hi. My son aged 15 is pre diabetes leading to type 1 caught early by blood results showing autoantibodies meaning his not type 2 as they diagnosed in January this year his now not diabetic leading to type 1. We're testing his bloods 8 times a day and ketones in the evening. We have been giving a care plan
What I don't understand is what to do when blood glucose is 6.4 and blood ketones are 0.6?
Also I'm going by the docs care plan but the diabetes nurse says she dnt think testing ketones every evening is necessary, but I'd rather go by the Peadiactic consultant?
Any advice please . Thank you.
 
6.4 and BG 6.4? Never known that to happen. I think testing ketones every evening is a bit over the top like the diabetes nurse said. Unless your son’s numbers have been high all day
 
Hi @Caris1983 🙂 Can you explain a little more about your son’s diagnosis. Are you saying that his doctors believe he’s developing Type 1? Is he on any insulin?

It wouldn’t be normal to test ketones that often. Type 1s usually only test when they’re ill or have high blood sugar (above 13-16). It depends whether your son is on insulin, and, if so, what insulins and when. If he’s not yet on insulin and you’re monitoring his blood sugar to watch for him tipping over into Type 1, then I would think testing ketones if he was high would be more normal.

Does his care plan say what to do when he gets ketones? Bear in mind that low levels of ketones aren’t uncommon eg when we haven’t eaten much for a while. These are sometimes called ‘starvation ketones’. Also, people who follow a very low carb diet get them.
 
I wouldn’t even bother testing for ketones unless my daughter had had very high blood sugars (high teens or above) for at least a couple of hours that weren’t coming down when she did correction doses of insulin, or if she was ill. Other than that it's a bit pointless, it's highly unlikely that you'd get more than a trace of them unless you haven’t eaten for a while. And trace levels are acceptable, 0.6 is right on the borderline of that. Why have you been told to test for ketones so often?
 
Hi @Caris1983 sorry to hear of your son’s diagnosis.

You mention that you are under the doctor’s care plan. Is that someone from the hospital or at you GP’s?
It will help us if we know whether your son is taking insulin and if so which ones. With Type 1 as has been found in the tests we will have antibodies in our system which are the culprits for the destruction of our beta cells which make insulin. This destruction, once started, continues until our bodies can no longer produce what we need. This is often triggered by another illness, which is when we are then more likely to produce ketones.

Can you tell us more about what the care plan that you have been given advises? I am on insulin and it is when I am ill or have glucose levels above 14 for an extended period of time that I start to test for ketones. Whilst my levels are in range (4-10) I would not test for ketones as these can be produced if we are not eating for any reason or by eating very low carbs.

Do come back with any information that you are happy to share and any questions that you have.
 
Have you been told to test 8 times a day every day? That seems a lot unless you suspect he’s hypo. On a normal day we would test 4 times or maybe 5 (meals and bedtime). We only test more if there are hypos. And as others have said we only test for ketones if BG over 14-16 for an extended period or if there are symptoms of illness then we might test at a lower BG. Ketones under 1.0 we would just monitor. Over 1.0 we have a treatment plan for giving insulin.
 
Welcome to the forum @Caris1983

This page might help you understand the basics of ketones

Ketones and diabetes

High levels of ketones in your blood or urine can mean you're at risk of developing diabetic ketoacidosis. This can be life-threatening, so it's important to be aware of your ketone level. On this page, we'll explain what ketones are and go through how to spot the symptoms. We'll also show you...
www.diabetes.org.uk www.diabetes.org.uk
 
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