The appearance of ketones is a dreaded thing for Type 1 Diabetics..
Generally ketones appear during prolonged high blood sugar levels when the body is not getting enough insulin, although in some cases blood sugar levels can be normal but ketones are still present (in the case of illness/vomiting)
Ketones are toxic chemicals that build up in the blood and urine when the body breaks down body fat for energy instead of the body using glucose. Remember, T1D cannot use the glucose consumed for energy without insulin.
When a Type 1 Diabetic does not have enough insulin in their body to process the glucose, ketones develop and can quickly build up in the blood and eventually body tissues leading to DKA (diabetic keto-acidosis).
DKA can be life threatening and lead to coma and/or death.
When on an insulin pump, ketones can build up much FASTER than someone using injections. When on injections, T1Ds will generally use 2 types of insulin – fast acting for meals and daily management and slow acting insulin as the “background” basal insulin which works for 24 hours and is given once a day (that is what WE used to do – every T1D is different – dependent upon Drs orders) Pump users rely on fast acting insulin 24hours a day, so if there is an issue with the pump site and insulin is not getting into the body a problem can develop MUCH faster as there is no background insulin working and they are getting ZERO insulin.
We were EXTREMELY lucky that Eden was not in DKA upon diagnosis – I clearly remember the doctors uttering those words in the Emergency Room that day but I had NO IDEA of what it meant or the potential consequences at the time.
Any time Eden has multiple HIGH blood sugar level readings in a row (300 or above) or if she is feeling unwell, we need to test her for ketones. We have a blood ketone meter for that but initially we needed to use urine ketone strips.. How FUN it was to try to get a child to give a urine sample when they are not feeling well! Urine ketone strips are also not as accurate and can be hours behind a blood ketone reading.
It is imperative to flush out ketones quickly before they build up to prevent DKA. PROMPT action is required whenever dealing with ketones to avoid hospitalization.
Eden has had trace/small levels of ketones many, many times. Trace/small levels of ketones can be easily treated at home with extra insulin and drinking fluids to help flush the ketones out of her body. If they continue to build up, that is another story.
We have only had to deal with moderate-large levels of ketones ONCE where I needed to call her doctor for assistance. That was certainly enough to freak me out! Very large ketones would warrant a trip directly to the ER and could very well be life threatening.
High blood sugar readings although not always an immediate health threat like a low blood sugar, they can invoke just as much worry.