Re: Ketones in Daughters Urine

Posted By THANK YOU FOR YOUR RESPONSE AND REASSURANCE!!!   CYNDI on April 05, 1999 at 22:01:47:

In Reply to: Re: Ketones in Daughters Urine posted by hfhs.md.hsw on April 05, 1999 at 13:33:44:






My 14 mo. old daughter has vesicoureteral reflux, so her urine is checked periodically.  She has had quite a few illnesses this winter, as I am sure most children have, which have been stomach flu's, chicken pox, colds, etc.  Lately, when her urine is checked, ketones are present in a moderate amount, but not glucose.  I am wondering if this could be the first clue to diabetes, or if the ketones are simply the body's reaction to the stress of illness.  I know that dehydration can cause these ketones to "spill," but a urinalysis the other day showed ketones and she is well. She has not truly displayed any other signs that concern me except that when she awoke this morning she wet through her diaper and EVERYTHING was soaked in her crib.  I know baby's do this, as she is my third, but she never has before and after reading what I have I just wonder.  Any information would be appreciated as to why this may be happening and if it is significant.  
Thank You!
Cyndi




Dear Cyndi:
Sorry it took so long to get back to you. Ketones in the urine reflect alterations in customary body metabolism. As you note, ketones are most often found in the urine during illness when children eat less. During such times, since little sugar is stored in the body, they metabolize their body fat as a source of energy. Ketones appear in the urine as a result. Ketones appear in children who have underlying severe inborn errors of metabolism. Such youngsters are obviously ill. It is true that children with diabetes mellitus spill ketones in the urine, but they spill sugar simultaneously. In fact, sugar appears in the urine in a child with diabetes before ketones do. Ketones may appear in the urine of otherwise healthy children in association with hypoglycemia. There is a form called ketotic hypoglycemia, which occurs in young children who are particularly susceptible to fasting. Your note does not suggest that you daughter has ever had low blood sugar. She conceivably might be having low blood sugar when she is asleep and the ketones in your urine when she is well might be reflecting this. Ketotic hypoglycemia is outgrown. Your pediatrician will be able to provide additional assistance and reassurance to you.
Thus information is provided for educational purposes only. I hope, though late, it steers you in the right direction.
HFHS.MD.HSW
Key Words: ketones, ketotic hypoglycemia