My 16 year old daughter was diagnosed with type�1 at age nine. She has a lot of anxiety problems. She was recently put on anti-depressants to help. I know that stress and anxiety can raise blood sugar levels, but can a person can get ketones too even if insulin is increased during these times?

Ketones may result from many causes, but usually are due to too little insulin. Other changes that can increase your risk for running ketones include decreased activity, not enough fluids, or dramatic stress in your life. If your daughter has ketones in her urine, you need to review a strategy for preventing that with your diabetes team.

MSB
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

It could be that your daughter is not actually getting all of the insulin that has been prescribed. If she is currently giving her own injections, it might help solve a mystery for you (or someone else) to alleviate some of her stress by taking over her self-management responsibilities. It would not be unusual to find that her control will dramatically improve, and the ketones will disappear. Also, be certain that the injection sites are free of puffiness (lipohypertrophy).

SS

[Editor’s comment: Anybody, with diabetes or without diabetes, will have ketones if they are not eating well. Severely restrictive diets and vomiting illnesses are common examples of situations where ketones are to be expected.

WWQ]