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Author Topic: Ketones = vomiting?  (Read 1302 times)

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Offline SarahMay

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Ketones = vomiting?
« on: February 13, 2016, 04:56:24 PM »
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  • Need a little vent + also wondering how YDMV. We've been dealing with a stomach bug in our household for two weeks, which I'm convinced is norovirus because it involves 8-12 hours of vomiting & diarrhea (those of you who know me on FB saw that it required IV hydration for both my T1's).

    Last night Isaiah, who had been better for a couple days, woke up and vomited again. Discovered he had BG of 300, moderate ketones by urine (we've burned through all our blood ketone strips!!), and a site cannula that was laying on his tush rather than inserted properly. CGM, naturally, was on the fritz so we didn't catch the high sooner. Got him all switched out & dosed up and he's been fine ever since (thank God, cause we are SO OVER THE PUKE).

    At first I thought the instance of vomiting was a relapse of the stomach virus (although none of the others have experienced this). However, our CDE thinks it was a result of the ketones. My kids have never, ever thrown up with ketones before (granted, we don't see it often--but we've had plenty of bent cannulas, etc.). He was only a few hours without insulin--although I had also reduced his basal earlier in the evening cause he was running just a little low for comfort at bedtime, especially since his carb factor is a little too strong post-illness. Our CDE's opinion is that he was more sensitive to the nausea due to ketones since his GI system isn't fully recovered from the stomach bug. (He's eating and acting fine, but as above we've had to under-cover his carbs so obviously he's not absorbing quite right yet).

    So I'm just curious... how often do you see vomiting with ketones/site failures?
    Sarah - wife to Aaron, mom to
    Matthew (9) non-D
    Jonah (8) DX 02/05/14 (Animas Ping, Dexcom)
    Isaiah (8) DX 01/10/13 (Animas Ping, Dexcom)
    Gideon (5) non-D

    Offline oddangela

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    Re: Ketones = vomiting?
    « Reply #1 on: February 14, 2016, 12:36:52 AM »
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  • Savannah definitely has nausea with ketones.  It's a particular kind of upset stomach for her (she says she feels ketone-y  lol)  and she pukes if you look at her crooked... so yeah.
    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 HD

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    Re: Ketones = vomiting?
    « Reply #2 on: February 14, 2016, 07:49:30 AM »
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  • It could definitely be the high and ketones, especially on the heels of a  <puke> bug.

    Hope he feels better this morning and no one else gets sick!  <fx'd>
    mum to Campbell (18) dx on 20 July 2007 Pumping with the t:slim & Dexcom, and Tom (14) non-D 

    Offline mymomtime

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    Re: Ketones = vomiting?
    « Reply #3 on: February 14, 2016, 09:04:02 AM »
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  • Puking as a result of ketones?  YUP!

    Kristen, now eight years in and 14, can most often tell a difference between pukey ketones and sickness. 

    A back story for you...

    BEFORE Kristen was dx, she was puking on a regular basis, I'm talking at least 2-4 times a month.  She would puke all night long, every 20 minutes, finally fall asleep, and then be completely fine the next day.  Never a fever, never any other symptoms.  Before she would start getting sick, she would be really shakey, and feel really bad.  AFTER dx:  It only happened a couple of times, but only the shakes and feeling bad never the puking.  We came to the conclusion that those puking episodes were from ketones. 

    NOW when she has a bad site (or forgets insulin) and gets ketones, we usually catch it before she pukes. We've found that she has to have ketones above 1.0 to puke these days, but she feels bad beginning around 0.3.  She tries her hardest NOT to puke.

    Also her mindset is different when she has ketones making her nauseous.  She is willing to drink, even if it initially makes her feel ill.  When she is sick, she will refuse drink.

    And we have found that shots work best for ketones.  They work faster anyway.  Our hospital protocol is to give 5%, 10%, or 15% of BASAL in addition to the correction for the high blood sugar.  It is different than others.  We do the correction and the ketones through a shot.  We disconnect pump and run the insulin through so it keeps track of the IOB.  THEN we increase basal for an hour at 10% and watch blood closely because sometimes she will tank.  WE also give ibuprofen.  Sounds strange, but ketones ALWAYS give her leg aches and a head ache.

    We get ketones a lot around here.  :-\

    Hope he feels better today.   <hug>
    Mom to Kristen (age 14) d/x 7/25/07 and Nathan (age 12) non-D, and Joseph (age 5)
    Pumping with Animas Ping since 2/12
    Pumped with MM 2/08-2/12

    Offline gsmama

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    Re: Ketones = vomiting?
    « Reply #4 on: February 15, 2016, 08:50:59 AM »
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  • Yes, Giovanni definitely pukes with lack of insulin ketones.
    Leslie in New Jersey: mom to ava 11 (non-d) and giovanni 13 (dx'd T1D 7/25/07 and Celiac 1/14)

    Offline stefaniemsmith1

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    Re: Ketones = vomiting?
    « Reply #5 on: February 15, 2016, 10:05:22 PM »
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  • Definitely nausea and vomiting when ketones are involved at our house. Headaches are another big sign of ketones at our house.

    And interestingly, in Kayleigh, puking can often cause her to have ketones. If she even vomits a tiny bit, like she might have ate too fast, we check her ketones.  She generally starts off with no ketones and they increase each time she vomits. And her BG is usually at target or low when this happens. So weird. Never happens with Mackenzie.

    Wife to my hero, Kevin
    Mom to Mackenzie (14, T1, DX 9/17/12, Pinging Green)
    & Kayleigh (7, T1, DX 11/20/12, Podding)

    Offline Arbeiter

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    Re: Ketones = vomiting?
    « Reply #6 on: May 09, 2017, 06:16:29 AM »
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  • More ketones does definitely lead to nausia and sickness.


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