My eight month old great-grandson was life-flighted to the hospital because his breathing was very shallow. He was non-responsive, and his oxygen and blood sugar levels were low. They checked his urine which showed high acid levels, and my granddaughter has to check hie urine for ketones, but no one told her what they mean. Are ketones caused by diabetes?

I think that your small grandson may have been suffering from a condition known as ketotic hypoglycemia. It has nothing to do with diabetes and is the result in infancy of a transient immaturity in the hormonal mechanisms of maintaining blood sugar. It usually results when an intercurrent infection diminishes appetite or when gastroenteritis also impairs the absorption of carbohydrate. This can lead to significant hypoglycemia, and, since glucose is the main fuel for the brain, low blood levels can induce coma and seizures. When the body has to depend on fat stores for essential energy, ketones are generated which can be measured in the serum or urine. Measuring ketones in the urine is actually an indirect (but much easier) way of measuring blood sugar. The condition is straightforward to treat and seldom has any long term effects, but there are other rare causes of infantile hypoglycemia which may need to be investigated at a later stage.

DOB

[Editor’s comment: Ketones may be found in a variety of situations, and are not specific for diabetes.

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