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Author Topic: 4.2 Ketones  (Read 2459 times)

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Offline apeanes

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4.2 Ketones
« on: October 21, 2014, 06:02:14 AM »
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  • so..Sean woke up this morning puking.   His pod cannula came out during the night.   His sugar was only 280 but his Ketones were 4.2.  The on call doctor had us do a correction by injection + 2 extra units. .told us water only for 1 hour then recheck. ..then he can have Popsicles and ice chips then Check again at 2 hrs and call back. ..His blood sugar is already dropping according to Dex..... any other suggestions?   we have never seen Ketones this high with sugar that low..normally we are over 400 before Ketones show up.
    Anna, mom to
    Sean, 12 dx 4/2010
    Phil, 5

    The life of man is like a game with dice; if you donít get the throw you want, you must show your skill in making the best of the throw you get. - Terence

    Humor prevents one from becoming a tragic figure even though he / she is involved in tragic events. - E. T. Eberhart

    Offline andrea

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    Re: 4.2 Ketones
    « Reply #1 on: October 21, 2014, 06:14:22 AM »
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  • Keep an eye on dex and restest before the hour if you feel necessary.

    I wouldn't have added an additional 2 units.

     <hug>

    Mom to Annelies, 14 (Dx 18 Mar 08~Pumping MM Oct 08-May 12, Omnipod May 12-Aug 13. tSlim Aug 13+ ~Dexcom Oct 11), Katy, 18 (non-D) and Jory (non-D/US Navy)
    God created wine to keep Army Wives from taking over the world
    My blog

    Offline Mich*09

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    Re: 4.2 Ketones
    « Reply #2 on: October 21, 2014, 08:08:21 AM »
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  • Are you confident in your ketone meter/strips?  Ketones take a lot of extra insulin.  If he has ketones at a lower than usual bg, and bg is dropping, I'd suspect that maybe there is a problem with the meter or strips.  Of course, anything is possible.  What I read over and over is that the extra insulin is needed because ketones are stubborn and eat up a lot of it.  Bg doesn't usually start dropping until ketones are pretty low to normal.

    Yet, we do have people here who get ketones with normal to low bg.  Everything is a variable in this damn disease.

    How is he doing now?
    Michelle
    Mom to - Jordan 22, Grant (19 dx 9/17/09 MM Revel 6/1/10), Brett 16

    Offline andrea

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    Re: 4.2 Ketones
    « Reply #3 on: October 21, 2014, 08:23:52 AM »
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  • Yeah, I get the extra insulin needed, I just question the amount given

    To echo, how is he?

    Mom to Annelies, 14 (Dx 18 Mar 08~Pumping MM Oct 08-May 12, Omnipod May 12-Aug 13. tSlim Aug 13+ ~Dexcom Oct 11), Katy, 18 (non-D) and Jory (non-D/US Navy)
    God created wine to keep Army Wives from taking over the world
    My blog

    Offline Mich*09

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    Re: 4.2 Ketones
    « Reply #4 on: October 21, 2014, 08:37:19 AM »
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  • Andrea, I think it all depends on his TDD.  Our recommended amount for ketones is a percentage of that, rather than x amount of units.  I agree with you that I wouldn't just give x amount without knowing where that amount came from.  I would not be happy if it was just a stab in the dark.
    Michelle
    Mom to - Jordan 22, Grant (19 dx 9/17/09 MM Revel 6/1/10), Brett 16

    Offline stefaniemsmith1

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    Re: 4.2 Ketones
    « Reply #5 on: October 21, 2014, 10:09:28 AM »
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  • Ugh!!!! How is he doing?

    Kayleigh is notorious for great to low BG and high ketones. Usually 80-100 for her and the inability to keep anything down. Thus far, the ketones spill as a result of her vomiting, rather than a symptom of ketones. Her biggest problem with the ketones is a very bad head ache.

    I've found that once I can start giving her insulin again (by injection) the ketones clear up quickly. The tricky thing with her is getting her sugar up.

    I've heard this for ketone management...

    for small ketones use 5% of total daily dose given as rapid acting insulin.
    for medium ketones, use 10% of total daily dose
    for large ketones use 15% of total daily dose

    (Note that I've never followed it because Kayleigh's never had high BG with ketones and Mackenzie hasn't had any ketones since DX.)

    Wife to my hero, Kevin
    Mom to Mackenzie (14, T1, DX 9/17/12, Pinging Green)
    & Kayleigh (7, T1, DX 11/20/12, Podding)
    www.prncsstefy.blogspot.com
    http://www.facebook.com/GigglyGirls

    Offline oddangela

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    Re: 4.2 Ketones
    « Reply #6 on: October 21, 2014, 10:21:45 AM »
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  • We have watched ketones change very rapidly.  Good luck!  Watch that bg I bet he'll tank from that much extra insulin.
    Angela- Mom to S- 8/9/04 (dx 5/4/11)  G- 6/4/08 and L- 4/3/12 and W- 3/18/15

    Offline stefaniemsmith1

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    Re: 4.2 Ketones UPDATE
    « Reply #7 on: October 21, 2014, 10:32:33 AM »
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  • I just texted Anna to find out how Sean is doing.

    He's on the mend. Took about 4 hours to get ketones down to 2.2 with a bs of 132.  He's stopped puking and is starting to eat some popsicles and juice and toast.  Poor kid puked 11 times between 5:30 and 8.

    Anna had to run into to work for a bit now that he's doing better and couldn't get on the website to update. Dad's going to knock the rest of those ketones out. 

    Wife to my hero, Kevin
    Mom to Mackenzie (14, T1, DX 9/17/12, Pinging Green)
    & Kayleigh (7, T1, DX 11/20/12, Podding)
    www.prncsstefy.blogspot.com
    http://www.facebook.com/GigglyGirls

    Offline oddangela

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    Re: 4.2 Ketones
    « Reply #8 on: October 21, 2014, 10:34:09 AM »
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  • Thanks for the update!  Hope the poor dude continues to feel better.
    Angela- Mom to S- 8/9/04 (dx 5/4/11)  G- 6/4/08 and L- 4/3/12 and W- 3/18/15

    Offline andrea

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    Re: 4.2 Ketones
    « Reply #9 on: October 21, 2014, 11:01:37 AM »
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  • Send her hugs from us

    Mom to Annelies, 14 (Dx 18 Mar 08~Pumping MM Oct 08-May 12, Omnipod May 12-Aug 13. tSlim Aug 13+ ~Dexcom Oct 11), Katy, 18 (non-D) and Jory (non-D/US Navy)
    God created wine to keep Army Wives from taking over the world
    My blog

    Offline apeanes

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    Re: 4.2 Ketones
    « Reply #10 on: October 21, 2014, 11:13:51 AM »
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  • ok, so I was able to get on and have a few seconds... he is doing lots better and complaining about how he hates popsicles....  as for the 2 units... well, that is typically what all of the endos in our practice tell us, but he did ask how much of a correction he was getting for the 280, and then he fussed at me because I guessed, he was like you should have that written down.. I do have it all, it is just on the phone I was talking to him on... so I told him it would be 3-4 units (it is actually 5) which is when he said do 2 extra units.  This is the endo I am not fond of, but he was the one on call.  I just freaked out because we have never had ketones that high (I checked them 3 times.. 3.8 then 4.2 then 4.2 just because I couldn't believe my eyes) they have never been over like 2.1 and then his bs was always over 400...  but long story short, he feels like crap from throwing up so much, was starting to get a headache and his sugar and ketones are doing better.. thank you so much all of you for your thoughts and prayers, with everything else I have going on I think my brain was trying to shut down...

    Stef... thanks for checking on me..
    Anna, mom to
    Sean, 12 dx 4/2010
    Phil, 5

    The life of man is like a game with dice; if you donít get the throw you want, you must show your skill in making the best of the throw you get. - Terence

    Humor prevents one from becoming a tragic figure even though he / she is involved in tragic events. - E. T. Eberhart

    Offline Mich*09

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    Re: 4.2 Ketones
    « Reply #11 on: October 21, 2014, 11:20:02 AM »
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  • Glad to hear he is doing better.   <hug>
    Michelle
    Mom to - Jordan 22, Grant (19 dx 9/17/09 MM Revel 6/1/10), Brett 16

    Offline HD

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    Re: 4.2 Ketones
    « Reply #12 on: October 21, 2014, 10:11:17 PM »
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  • So glad he's doing better. 

    We've gone through the normal-low bgl with high ketones, and it is scary.
    Hugs to all of you.
    Heather
    mum to Campbell (18) dx on 20 July 2007 Pumping with the t:slim & Dexcom, and Tom (14) non-D 





     


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