From Colorado, USA:
One of my children has diabetes and another is "prediabetic", meaning that he has multiple autoantibodies. Recently, both children had a stomach virus, and both had large ketones with associated nausea as the first sign that they were sick. Do large ketones in a non-fasting, nondiabetic child during illness suggest that he is borderline diabetic? So far, his fasting levels are still below 126 mg/dl.
Ketones are too insensitive to be a "marker" of diabetes. The presence of multiple autoantibodies does much better to indicate the ongoing autoimmune process that lies "under the surface" and over time slowly leads towards severe insulin deficiency with consequent appearance of the classical signs and symptoms (such as ketones in the urine and blood, increased urination, increased appetite and usually weight loss), that is, clinically-apparent type 1 diabetes. Fasting blood sugars taken before this stage can be quite normal or slightly elevated even though below the cutoff level of 126mg/dl.
This doesn't mean that your son is home free, though. If his insulin response is deteriorating, blood sugars will go up or sugar may be present in the urine in the near future before ketones appear.
Original posting 11 Feb 1999
Posted to Diagnosis and Symptoms
Last Updated: Tuesday April 06, 2010 15:09:01
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