Ketones and Sick Days

Ketones form when the body cannot use sugar for energy and burns fat instead. They are acidic, and enough of them cause diabetic ketoacidosis — a medical emergency. Babies reach that point faster than older children do.

This is not a remote risk in this condition. Indian studies of infants with diabetes found that most were already in ketoacidosis by the time the diagnosis was made.

Any illness — fever, a cold, a stomach infection, teething with poor feeding — pushes blood sugar up and ketones with it.

During any illness:

1. Check blood sugar much more often — your team will tell you how often.
2. Check ketones if you have been shown how, particularly if readings are high or your baby is vomiting.
3. Keep fluids going in small, frequent amounts.
4. Continue treatment, adjusted on your team's advice.
5. Watch for dehydration: fewer wet nappies, dry mouth, no tears, a sunken soft spot.

Go to hospital without delay if your baby is vomiting repeatedly, refusing all feeds, drowsy or hard to wake, breathing fast or deeply, has a sweet or fruity smell to the breath, or has moderate to large ketones.

Keep a small sick-day kit ready: ketone strips, oral rehydration salts, a thermometer, and your team's number written on paper as well as saved in a phone.