type 1 diabetes and keytones

[lillylh21]

My fiance has type 1 diabetes. He takes pretty good care of himself.  He is almost fanatical about checking his blood sugar.  On his one touch ultra some times it says something about keytones. So my question is..   What are Keytones and how are you supposed to test for them.

[Seandc]

I am not a medical professional but I have been type 1 diabetic for 12 years and have several siblings who are also type 1 diabetic so it's safe to say that I know what I'm talking about.

The primary cause of keytones in the blood system is a high blood sugar.  Stress and sickness simply make it so that keytones can develop at blood sugars that are normally not good but easily dealt with.  For example, when my blood sugar goes as high as 200 I will be able to tell that it is high and needs to be dealt with, but keytones will not develop until my blood sugar is as high as 250 or greater.  If I am under stress or am sick my body will often develop keytones with a blood sugar of 180 to 200.  If I keep my blood sugar between 80 and when 120 though, no matter how sick or stressed I am, I will not develop keytones.

As far as the difficulty breathing goes, high blood sugars greatly effect different muscel groups.  I have only once experienced difficulty breathing due to a high blood sugar.  It is a very scary experience and the best way to deal with it for myself and my brother who has experienced it several times has been get the appropriate amount of insulin and drinking LOTS of water.  When it happened to myself my blood sugar went to an amount slightly over 300, I took the appropriate amount of insulin and drank nearly 2 gallons of water in 2 1/2 hours which obviously resulted in frequent visits to the bathroom but it did help to clear the keytones from my system.  After about 5 hrs of being in that condition I began to recover and was able to return to feeling more secure about my health.  

Should your grandson begin to develop trouble breathing I highly suggest getting him to a hospital, and giving him as much water as he desires.  His body will make him extremely thirsty, but don't hesitate to give him the water, his body is trying to wash the keytones out.  Take him to the hospital because high blood sugars can cause muscels to seize.  I've had my entire back go rigid and it is in no way a pleasent experience, I've broken many bones in my life and I would trade the pain of a seized muscel for a broken bone any day. The ride to the hospital is going to have lots of stops because the water he drinks will go right through him, but make the stops, everytime he goes to the bathroom he is getting a small amount of those keytones out of his system.

[hayden01]

when and how long does it take for these keytones to mellow out until they are gone and no longer continue to be life threatening?  my grandson is 7 years old and recently puked extensively for hours and was hospitilized at an er for hours.  since which is 3 days later he is still showing high levels of keytones and told me he was having a hard time breathing.  will a flu type disease cause this to rise in blood or is it mainly contributed to stress?

[JDRF-Team-gg]

Ketones are acids that build up in the blood.  They appear in the urine when your body doesn't have enough insulin.  Your fiance's bg meter must have an indicator, based on his bg reading that tells him when he should be checking for ketones.  My daughter's endocrinologist has recommended that she test her urine for ketones if her bg is over 170 as she is on an insulin pump.  Ketones can poison the body and some action should be taken if the urine test strip indicates that they are present.  Ketones are a warning sign that your diabetes may be out of control or that you are getting sick.  Ketones are flushed from your body by drinking lots and lots of water or non-caloric fluids.  Ketoacidosis can occur if the ketones are not flushed immediately.  Ketoacidosis means dangerously high levels of ketones.

What are the warning signs of ketoacidosis?

Ketoacidosis usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. The first symptoms are:

Thirst or a very dry mouth
Frequent urination
High blood glucose (sugar) levels
High levels of ketones in the urine
Next, other symptoms appear
Constantly feeling tired
Dry or flushed skin
Nausea, vomiting, or abdominal pain (Vomiting can be caused by many illnesses, not just ketoacidosis.  If vomiting continues for more than 2 hours, contact your health care provider.)
A hard time breathing (short, deep breaths)
Fruity odor on breath

Ketones appear typically when blood sugars run high, but it is considered common for them to show up under times of high stress. Being in contact with your healthcare team to adjust your insulin doses during this time is very important. From what I have recently read, when stress occurs, our bodies prepare to take action. This preparation is referred to as the fight or flight response. In this period of stress, most hormone levels shoot up. Their main purpose is to make a lot of stored energy...glucose and fat...available to cells. The fight or flight response does not work well in people who have diabetes. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood. You need to continue to keep an eye out for ketones, even when your blood sugar may not seem high to you. Ketones can show up even because you have not been eating for a period of time.

If ketones are present, no matter how small or large they are, repeat tests should be done until they are all gone.  If ketones continue to be present after pushing fluids, or if they are increasing it is extremely important that a medical professional be contacted for their advice as this can be a life threatening condition that can get out of control really fast.