My five year old son, who has had type 1 diabetes since he was 15 months old, will be starting full-time kindergarten this year and participating in physical education class. Can you explain to me why exercise needs to be delayed if ketones are present? Are there risks or complications to exercising when there are ketones present ?

Ketones when present indicate that fat is being burned or metabolized by the body. Under usual circumstances, this only happens when starvation is occurring or no food is eaten during an illness. When someone has diabetes and is insulin deficient, fats are sometimes used as energy source because there on not enough when insulin. This occurs at diagnosis before someone knows they have diabetes or during severe stress, illness, surgery, etc. So, if high sugars and positive ketones occur, this usually indicates more severe insulin deficiency, and thus the reason to avoid exercise during such times. On a day to day basis, there should not be positive ketones so in kindergarten there is not much reason to worry as long as it is not a “sick day.”

SB