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From Colorado, USA:

The other morning, my five year old son woke up and was very lethargic and very thirsty. I have been occasionally testing his blood sugar and decided to test him. (I am having problems with my own blood sugar so I have been watching signs in my son also). He was 60 mg/dl [3.3 mmol/L]. I gave him breakfast, which consisted of cereal with milk. Two hours later, he was perkier and I tested him again and he was 188 mg/dl [10.5]. I have some ketone sticks and urine tested him and he tested greater than 160 mg/dl [8.9 mmol/L] that the stick allows for (large). Two hours later, he tested the same way with his blood sugar and ketones. I had him drink a lot of water and then tested him two hours later. His ketones were down to 90 mg/dl [5.0 mmol/L] and his blood sugar was 155 mg/dl [8.6 mmol/L], now four hours after breakfast. I gave him lunch and then tested him two hours later and his ketones were past large again and his blood sugar was back up to 187 mg/dl [10.4 mmol/L] again. I gave him a lot more water and waited three hours longer and the ketones were down to trace, but his blood sugar never went under 140 mg/dl [7.8 mmol/L] the rest of the day. I last tested him at 11 p.m. I monitored him all the following day and he had small to trace ketones and blood sugars were only slightly elevated.

I wanted to know what your thoughts were about this. I have read it is possible to have ketones if one is fasting for long periods; on a high protein/low carbohydrate diet; or sick/vomiting or dehydrated. He was none of these things so, I am wondering if a non-diabetic could ever get large ketones. Or, could this be an early sign of diabetes? If this is not early diabetes, what could it be?

In the past few weeks, I have tested him over around 175 mg/dl [9/7 mmol/L] twice and at 70 mg/dl [3.9 mmol/L] once. I haven't tested his ketones for months, but he was always normal before. For the past week, he has been drinking a lot more water than normal. The day before this happened he was very lethargic, also.


Ketones only indicate that the body is burning fat. So, it could happen with starvation, illness (not eating) - and insulin deficiency. The blood glucose readings you report are definitely abnormal, so I would consult with your physician and consider strongly consultation with a pediatric diabetologist since this could be early diabetes. Rather than wait for him to lose weight and risk dehydration or diabetic ketoacidosis, I would certainly monitor his blood glucose levels closely and see if there are any other markers of diabetes besides the intermittent high blood glucose levels.


Original posting 14 Nov 2006
Posted to Diagnosis and Symptoms


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Last Updated: Tuesday April 06, 2010 15:10:10
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