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From Connecticut, USA:

My 3 year old daughter has IDDM. She was diagnosed at age 15 months. How long does it take for ketoacidosis to appear? She takes two insulin injections a day. We test for ketones if she has two consecutive readings over 250. She has never shown more than small ketones. We are worried that in someone so small it may happen overnight if she goes to bed high and we haven't tested for ketones.


The speed at which ketoacidosis develops depends on many factors. If a child develops a fever, virus, or infection, ketoacidosis can develop in a matter of hours if extra insulin is not given.

If a child is gradually "outgrowing" her dose of insulin, it is unlikely that ketoacidosis would develop in a few hours if the blood sugar was high, but there were no ketones in the urine, and the child was feeling well.

Some children can run blood sugars over 250 for days or even weeks and not develop ketoacidosis if they are not otherwise sick and have no ketones in the urine (of course this is not recommended!).

A blood sugar of 300 with ketones in the urine in a child with a fever is more likely to progress to ketoacidosis quickly in a few hours than a blood sugar of 400 in a child who feels well and has no ketones in the urine.

The most important thing is to check your child's urine for ketones frequently when she is sick or running high blood sugars and take extra insulin as recommended by your physician.


Original posting 30 Aug 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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