
August 2, 1999
Hyperglycemia and DKA
Question from Virginia, USA:
My daughter is almost 12 and was diagnosed at 16 months. Though she frequently has high/fluctuating blood sugars, she rarely shows ketones on ketone strips. Why would she not show ketones when her sugars are high? Can kidney problems be determined through a blood test when other routine tests are done?
Answer:
Ketones are present in the urine of diabetic patients having high blood sugars only when there is a significant imbalance of overall metabolic control with insulin shortage and consequent increased utilisation of fatty fuels, such as in DKA, or after a serious hypo with rebound hyperglycemia. Kidney problems are routinely screened when routine tests are done (i.e., through microalbumin in the urine or blood creatinine levels).
MS