July 31, 2002
Hyperglycemia and DKA
Question from Topton, Pennsylvania, USA:
My 21 month old son, diagnosed with type 1 diabetes at the age of seven months, has been waking up with high blood sugars and on some occasions with moderate or large ketones, and I read that one sign of rebounding is a trace of ketones in the urine. Can rebounding cause large amounts of ketones? Is this from being high all night? His nurse practitioner would only say that younger children tend to get ketones more easily.
Answer:
Generally, children are more prone to having rebound hyperglycemia, also called the Somogyi Effect. this is to a more vigorous hormonal response to low blood sugar than is seen in adults. During the hours of increased levels of counter-regulatory hormones, there will be an overproduction of endogenous glucose and insulin resistance, both possibly leading to overproduction of ketones with spillage into the urine.
Given the picture you describe, I’d suspect this might be what’s happening. My best advice would be to check his blood sugar levels during the night (around 03:00 am) to confirm it.
MS
