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September 6, 2001

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Question from Houston, Texas, USA:

My two and half year old daughter and our friend's four and a half year old son have both had diabetes for two years, and my daughter rarely gets ketones whereas the four year old gets moderate to high ketones multiple times a month. Do some kids just get ketones more often than others? What would account for the difference in the way their bodies function?

Answer:

Children’s metabolisms are clearly individualized. The four year old appears to break down fats more quickly. I expect one is thinner than the other and possibly more active. Energy needs are different and one goes to the fat metabolism system. I don’t really think it is the diabetes management, but certainly lots of highs can be associated with ketones. I bet, though, you see ketones with seemingly normal (for diabetes) sugars. Monitor and don’t get surprised.

LD