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From Katy, Texas, USA:

I have a two and half-year-old son who woke up last Sunday very sleepy, quiet, and lethargic. We finally decided to take him to the Emergency Room (ER). They told us his blood glucose was 177 mg/dl [9.8 mmol/L] and he had a small amount of ketones. Later, after I.V. fluids, they tested his urine, which came back with glucose and ketones (they mentioned a number of 100). He was very thirsty and had a dry mouth and the ER doctor said he had ketones in his mouth. They transported him to Texas Children's that night for further tests, but they all came back normal. I'm very confused! The pediatrician tested his blood sugar and urine the next day after fasting and it came back normal. He is acting perfectly normal now, except we've noticed he is drinking more fluids and constantly wanting to eat sweets (more than before all of this).

Could this be the "honeymoon period" I've read about? He has not yet been diagnosed with anything, but the test results from the first hospital combined with his behavior are very concerning. What do you think this all means?


Most likely, you are describing a stress reaction to an illness. We see elevated glucose with stress. The vast majority of most individuals like this do not go on to get diabetes.

Ketones come when children or adults fast. I expect he didn't eat well the day before and developed ketones, as he likely has done before, because of the poor intake. This is a normal fasting observation.

There is a condition called ketotic hypoglycemia. I don't think he had that because it is defined as hypoglycemia, low glucose, not high glucose with ketones. It is observed in little children in the early morning as they have run out of fuel. The high glucose makes that unlikely. If he regularly acts ill in the morning, especially after a busy day when he doesn't eat well, you may want to bring it up with your doctor.

This bottom line is: It is unlikely that is diabetes and it is not going to be diabetes.


Original posting 9 Apr 2007
Posted to Diagnosis and Symptoms


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Last Updated: Tuesday April 06, 2010 15:10:12
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