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Ketones Non Diabetic Child

Pediatric Non-diabetic Ketoacidosis: A Case-series Report

Pediatric Non-diabetic Ketoacidosis: A Case-series Report

Pediatric non-diabetic ketoacidosis: a case-series report We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Pediatric non-diabetic ketoacidosis: a case-series report Ke Bai, Yueqiang Fu, [...], and Min Zhu This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age 18years; 2) urine ketone positive ++ or >8.0mmol/L; 3) blood ketone >3.1mmol/L; 4) acidosis (pH < 7.3) and/or HCO3 < 15mmol/L; 5) random blood glucose level < 11.1mmol/L. Patients who met the criteria 1, 4, 5, plus either 2 or 3, were defined as non-diabetic ketoacidosis and were included in the report. Five patients with 7 episodes of non-diabetic ketoacidosis were identified. They all presented with dehydration, poor appetite, and Kussmaul breathing. Patients treated with insulin plus glucose supplementation had a quicker recovery from acidosis, in comparison to those treated with bicarbonate infusion and continuous renal replacement therapy. Two patients treated with bicarbonate infusion developed transient coma and seizures during the treatment. Despite normal or low blood glucose levels, patients with non-diabetic ketoacidosis should receive insulin administration with glucose supplementa Continue reading >>

Ketosis Or Acetone In Children

Ketosis Or Acetone In Children

Acetone in children (also called ketosis or ketoacidosis) is a disorder that manifests itself when glucose stores are finished and the body begins to burn fat. Acetone occurs naturally in small amounts during normal metabolic processes and is eliminated from the body through respiration. The body naturally increases acetone levels in situations where the energy requirement is greater, such as: In newborns, even if they feed on breast milk; In children up to 12 years old, but especially in children from 2 to 10 years of age. The body produces acetone when it burns fats, so more acetone is produced with a low carbohydrate diet. When the sugar reserves in the blood are finished, the liver produces energy through the oxidation (chemical rationing) of the fatty acids. The first two enter the bloodstream and are used to produce energy in certain organs, for example: The brain can only use glucose and ketone bodies as a source of energy. When ketone bodies accumulate in the blood, they are eliminated through urine. Acetone is eliminated through respiration. The production of ketone bodies is excessive; The body can not eliminate these substances. The type 1 diabetes (or juvenile) also affects children and is characterized by a very low level of insulin in the blood. Under these circumstances, cells use stored fats as an energy source. The combustion of fats causes an excessive amount of acetone, which gives rise to ketosis in diabetic children. Themetabolic diseasessuch as diabetes mellitus ( type 1 and type 2 ) can cause ketoacidosis; In cases ofextreme hunger, carbohydrates stored in the body are depleted and the body begins to convert fats into ketones. If the child does not feel like eating because he is sick or consumes too many calories because he has a fever, the body Continue reading >>

Ketone Bodies (urine)

Ketone Bodies (urine)

Does this test have other names? Ketone test, urine ketones What is this test? This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces substances called ketones. The ketones end up in your blood and urine. It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. Why do I need this test? You may need this test if you have a high level of blood sugar. People with high levels of blood sugar often have high ketone levels. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels. People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders. Checking your ketones is especially important if you have diabetes and: Your blood sugar goes above 300 mg/dL You abuse alcohol You have diarrhea You stop eating carbohydrates like rice and bread You're pregnant You've been fasting You've been vomiting You have an infection Your healthcare provider may order this test, or have you test yourself, if you: Urinate frequently Are often quite thirsty or tired Have muscle aches Have shortness of breath or trouble breathing Have nausea or vomiting Are confused Have a fruity smell to your breath What other tests might I have along with this test? Your healthcare provider may also check for ketones in your blood if you have high levels of ketones in your urine Continue reading >>

Diabetes Mellitus Type 1 In Children

Diabetes Mellitus Type 1 In Children

GENERAL INFORMATION: What is diabetes mellitus type 1? Diabetes mellitus type 1 is a disease that affects how your child's body makes insulin and uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 1 diabetes develops because the immune system destroys cells in the pancreas that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your child's risk for diabetes. What are the signs and symptoms of diabetes mellitus type 1? More thirst than usual Frequent urination Feeling hungry most of the time Weight loss without trying Blurred vision How is diabetes mellitus type 1 diagnosed? An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months. A fasting plasma glucose test is when your child's blood sugar level is tested after he has fasted for 8 hours. Fasted means he has not eaten anything or had anything to drink except water. An oral glucose tolerance test starts with a fasting blood sugar level check. He is then given a glucose drink. His blood sugar level is checked again after 2 hours. Healthcare providers look at how much your child's blood sugar level increases from the first check. An antibody test may show that your child's immune system is attacking his pancreas. How is diabetes mellitus type 1 treated? Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your child's blood sugar at a normal level. Your child may need 3 to 4 doses of insulin each day. Insulin can be injected or given through an insulin pump. Ask your child's healthcare provider which method is best for your child. You Continue reading >>

Kids And Ketones: Checking And Treating High Blood Glucose

Kids And Ketones: Checking And Treating High Blood Glucose

Low blood glucose levels usually have warning signs such as shaking, sweating and rapid heartbeat, but high blood glucose levels can be silent until things start to get out of control. The staff in the Joslin Pediatic Clinic has this advice. One of the vital warning signs of an impending diabetic crisis is the appearance of ketones in the blood or urine. For children with type 1 diabetes and their parents, understanding the role of ketones in a diabetic emergency and knowing how to check for them and what to do if your child has them can mean the difference between a good night’s sleep and many tense hours in the emergency room. (Ketoacidosis almost always occurs in people with type 1 diabetes) Too little insulin for too long a time initiates a cascade of hormonal changes in the body that can lead to the dangerous condition of diabetic ketoacidosis (DKA). If left untreated, it can lead to coma and death. In the face of inadequate circulating insulin, glucose builds up in the blood instead of moving into the tissue cells where it would be used for fuel. Without glucose to burn for energy, the body turns to fat for fuel. The special type of fat it uses is called ketones. Because ketones are an acid, the body needs to supply a base (the opposite of an acid) to neutralize their effects and maintain the blood’s natural pH. However, the body’s supply of base,such as NH3 (anydrous ammonia) (is limited and at some point the system is overwhelmed and the blood pH starts to decline. This drop in blood pH is one of reasons ketoacidosis is so serious. The body can’t accommodate changes in blood pH well. Illness can often be a precipitating cause of DKA. Infection can spike glucose levels and additional insulin is often required. If the needs for additional insulin aren’t Continue reading >>

Reasons For Ketones In Urine

Reasons For Ketones In Urine

What are ketones? Everybody has ketones. The body produces ketones when there is not enough insulin that will convert sugar into energy. Ketones are chemicals produced by the liver from fatty acids. The liver then sends ketones into the bloodstream, so the tissues and muscles can utilize them as fuel. People without diabetes don't have an issue with this process. However, people with diabetes can have too much buildup of ketones in the blood, which can be life-threatening. If you have type 1 diabetes, you might need a ketone test. In type 1 diabetes, a person's immune system attacks the pancreas, which produces insulin. Without enough insulin, the levels of blood sugar rise. Individuals who have type 2 diabetes can also experience high ketone levels, but not as common as with those who have type 1 diabetes. Signs to Test for Ketones Your doctor will probably ask for a ketone test when you have the following conditions: A blood sugar of more than 250 mg/dl for two consecutive days Excessive thirst Vomiting You have an illness You have an injury You are pregnant Tests for Ketones Ketones are tested through a urine analysis. You can purchase a ketone test kit at your local drugstore and test your urine at home. A ketone test can also be done in your doctor's clinic. To test for ketones in your urine, you have to pee in a sterile container to get a urine sample. After collecting the urine sample, do the following steps: Dip the test strip into the urine sample. You can also hold the strip under your urine stream. Gently shake off excess urine from the test strip. You will notice that the test strip will change in color. the directions will tell you how long that takes. Follow the instructions and check the strip color against the provided chart in your test kit. The corresp Continue reading >>

Ketones: Clearing Up The Confusion

Ketones: Clearing Up The Confusion

Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>

Non-diabetic Hypoglycemia In Childhood

Non-diabetic Hypoglycemia In Childhood

WHAT YOU NEED TO KNOW: What is non-diabetic hypoglycemia? Non-diabetic hypoglycemia is a condition that causes your child's blood glucose (sugar) level to drop too low. This type of low blood sugar level can happen in children who do not have diabetes. When your child's blood sugar level drops too low, his brain cells and muscles do not have enough energy to work well. Glucose is also important for helping your child's brain grow normally. What causes non-diabetic hypoglycemia in children? The cause of non-diabetic hypoglycemia may be unknown. It may be caused by certain medical conditions. These include hyperinsulinism (your child's body makes too much insulin), hypothyroidism, or prediabetes. It may also be caused by fasting, which can lead to ketotic hypoglycemia. This is a condition that causes the body to change fats into glucose for energy. What are the signs and symptoms of non-diabetic hypoglycemia in children? Hunger or nausea Sweating more than usual Anxiety, confusion, or changes in behavior Fast heartbeat Weakness Blurred vision Dizziness or lightheadedness Headache How is non-diabetic hypoglycemia in children diagnosed? Healthcare providers will ask about your child's symptoms and your family's health. They may ask you about the amount of time between your child's last meal and the start of his symptoms. They may also ask if any other children in your family have hypoglycemia, or have had it in the past. Blood tests are done to measure your child's blood sugar levels. These tests may also be done to find the cause of your child's hypoglycemia. Fasting tests may be done. Healthcare providers watch your child closely during a period of time in which he does not eat. This test is done to see if, and when hypoglycemia occurs. An oral glucose tolerance test may Continue reading >>

Ketones In 4 Y.o. Non-diabetic

Ketones In 4 Y.o. Non-diabetic

Although I am an RN, I am still worried about my son.I took him into the doc this past Wed. for unusually poor behavior the past couple of weeks, and a couple of episodes of unrinary incontinence.I thought he may have a UTI or earache.They did a urinalysis and the only abnormal was KETONES-15 (low).They want to repeat it in a month. Never a fever, is a persnickty eater, but does have an apple and P.B. everyday and a whole wheat english muffin with cream cheese in the am, or toast with "dippy" egg.So he is NOT even close to starving! Why are these Ketones showing up?I did check a blood sugar on him (using my neighbors BGM, just for my own piece of mind.)He had not eaten yet and it was 119.I called to doc's office with this and they told me to take him to the ER right away.....?Well I didn't because he was awake, alert, and playing.Should I be concerned?I've checked his urine with dipsticks 2 times.Once he had a tract amount of ketones, and once it was negative.His blood sugar this am before eating was 98.Again, am I missing something here, should I be concerned?Thanks! Hi Lorit!I am a volunteer, not a medical professional, and a Mom of an 18 year old girl who was diagnosed at the age of 21 months.Please verify any information given, with your son's physician.I am not telling you this because I think your child has diabetes (his fasting bg's don't seem too high to me), just thought it may make you feel more comfortable knowing my story and give you a different perspective.Practically all of the folks that I've met through The Juvenile Diabetes Research Foundation over the past 17 years, tell of misdiagnosis of their child's diabetes.When my daughter was drinking & peeing non-stop, my doctor diagnosed a UTI and after a couple of days with no change, ordered a stool sample Continue reading >>

When To Worry About Ketones

When To Worry About Ketones

“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>

Ketone Testing: About Your Child's Test

Ketone Testing: About Your Child's Test

What is it? A ketone test checks for ketones in your child's blood or urine. Ketones are made when the body breaks down fat for energy instead of using sugar. This can happen when children with diabetes are ill or don't get enough insulin. Newer home blood sugar meters can measure ketone levels in the blood. You can also use home urine tests to measure ketones. Why is this test done? Measuring your child's ketones is recommended whenever your child has symptoms of illness, such as nausea, vomiting, or belly pain. These symptoms are similar to symptoms of high blood sugar and may mean that your child has diabetic ketoacidosis. This condition is very serious and needs immediate treatment. How can you prepare for the test? In general, your child doesn't need to prepare before having this test. Your doctor may give you some specific instructions. What happens during the test? Blood test in a doctor's office or hospital: A health professional takes a sample of your child's blood. Blood test at home: Some home blood sugar meters can also measure blood ketones. You use the same finger-prick method that you use to measure your child's blood sugar. Home urine test: Collect a sample of urine in a clean container. Follow the manufacturer's directions on the bottle of test strips or tablets. What else should you know about the test? With the home urine test, if either the test strip changes colour or the urine changes colour when the tablet is dropped into the sample, ketones are present in your child's urine sample. The test results are read as negative to 1+ to 4+, or small to large. Blood ketone tests using a meter display the result on the monitor. Your doctor can tell you what ketone range is high for your child (for example 0.6 mmol/L or higher). Your doctor may recommend tha Continue reading >>

Ask The Diabetes Team

Ask The Diabetes Team

Question: From Houston, Texas, USA: Are moderately high ketones ever caused by anything else besides diabetes? I have IDDM but there's no prior family history. I found out that my 4 year old son had moderately high ketones in his urine the morning after the day I took him to the pediatrician for an asthma problem. I have a good pediatrician and I want to prepare myself for what he might say. My son has been sick for six months with asthma difficulties that get better only on steroids (liquids) but the wheezing and dry coughing comes back when the steroids wear off. He's never been this sickly. He has gained no weight and seems much skinnier to me, but last time I mentioned this to the doctor he said wait until he's well and we'll weigh him again. I'm thinking of asking for a glucose tolerance test. My son is terrified of needles and I don't want to push the unnecessary. Answer: Ketones are produced when the body breaks down too much stored fat to get extra fuel for energy. In fact, in normal metabolic conditions, the main energy source of our human machinery are carbohydrates (i.e., glucose). Quite often very young children with normal (or low) blood sugar are unable to get enough sugar from their stored fat and from stored sugar (glycogen) in the liver while they're are sleeping during the night or are in a "starvation" situation or not taking in normal calories and fluids: then most of the time they can have ketones in their urine in the morning. Stress and illnesses like asthma, flu, and infections, put a stress on the body of a child and this can make his body produce ketones. This usually occurs because in these conditions the body makes hormones like epinephrine and cortisol which cause the body to break down its own fat deposits; this would explain why your son h Continue reading >>

Ketones — Urine

Ketones — Urine

Definition Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. A urine test can be done to check the level of ketones in your body. Alternative Names Ketone bodies - urine; Urine ketones How the test is performed The test requires a clean catch urine sample. To obtain a clean catch sample, men or boys should clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl to clear the urethra of contaminants. Then, put a clean container under your urine stream and catch 1 to 2 ounces of urine. Remove the container from the urine stream. Cap and mark the container and give it to the health care provider or assistant. For infants, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia. Diaper as usual over the secured bag. This procedure may take a couple of attempts -- lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory. Urine ketones are usually measured as a "spot test" using a dipstick coated with chemicals that react with ketone bodies. The dipstick is dipped in the urine sample, and a color change indicates the presence of ketones. How to prepare for the test You may have to eat a special diet, and you should stop taking a Continue reading >>

Diabetes: Urine Testing For Ketones

Diabetes: Urine Testing For Ketones

Ketones in the urine mean that the body cells are using fat for energy instead of glucose. A large amount of ketones in the urine is a danger sign and can mean the start of a serious illness. Call your child's doctor or nurse educator if your child has a large amount of ketones in his/her urine. Things that can cause the urine ketone to be positive are: too much food injury or illness too little insulin infection dehydration certain medicines Urine is Tested for Ketones: Whenever your child does not feel well. If your child's blood glucose is greater than 300 (or as directed by your child's doctor). Your child's doctor will tell you how often you should check your child's urine for ketones. To Collect a Urine Sample: Have your child urinate (void) into a clean container or on the test strip. NOTE: If your child wears a diaper, try placing cotton balls in the diaper and squeeze the urine on the test strip. What You Will Need: Fresh urine sample Ketone strip Pen or pencil Record Book Clock or watch with a second hand Ketone strip color chart Procedure Using Strip Method: There are different kinds of strips that can be used to check for ketones in the urine. Several kinds are Ketostix®, and Ketodiastix®,. Read the instructions on your brand. You may want to ask your pharmacy to order individually wrapped strips because opened bottles expire in 90 days. Check the date on the bottle to be sure the strips are not expired. Dip the strip into the urine. Wait for the amount of time stated for the type of strip you are using. Compare the color of the strip with the color chart. Record your results, date, and time in record book. Throw away urine and strip. Call your doctor or nurse educator if you have moderate or large ketones. Disclaimer: This information is not intended to s Continue reading >>

Nondiabetic Ketosis In Children

Nondiabetic Ketosis In Children

Interest in the occurrence of ketosis is no longer confined to diabetes. The production of undue amounts of ketone substances associated with an augmented output of organic acids—ketonic acidosis—and a lowering of the alkali reserve is often encountered in childhood. Sometimes it is the accompaniment of cyclic vomiting. The phenomena may develop quite suddenly in apparently healthy children. The dietary and metabolic aspects of ketosis have been elucidated in recent years. Ketogenesis is an outcome of inadequate metabolism of carbohydrate in the body. The dictum that "fats burn in the flame of the carbohydrates" has long been accepted; and Woodyatt4 has added the appropriate interpretation that when the proportion of fats is too great for the fire it "smokes" with unburned fats and ketone substances. The present consensus has led to the adoption of a ketogenic-antiketogenic ratio as expressive of the relative proportions of the proximate principles in our nutriment Continue reading >>

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