Ketostix

KETOACIDOSIS

Ketoacidosis is often associated with diabetes/sugar problems. It can cause shortness of breath, sweating, and in severe cases, coma and then death.

Here is a little bit of info:

Ketoacidosis; Diabetic coma

Diabetic ketoacidosis is a complication of diabetes mellitus caused by the buildup of by-products of fat metabolism (ketones), which occurs when glucose is not available as a fuel source for the body.

Causes, incidence, and risk factors

People with  SMA act a lot like  diabetics. Diabetics lack sufficient insulin, a hormone needed to allow the body to use glucose (a simple sugar) for energy. When glucose is not available, body fat is broken down instead. The by-products of fat metabolism are ketones. When fat is metabolized, ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis develops when the blood becomes more acidic than body tissues as a result.

Blood glucose levels become elevated (usually higher than 300 mg/dL) because the liver produces glucose to try to combat the problem and because cells cannot take up that glucose without insulin. Diabetic ketoacidosis may lead to the initial diagnosis of type 1 diabetes, as it is often the first symptom that causes the person to come to medical attention. It can also be the result of increased insulin needs in someone already diagnosed with type 1 diabetes. Infection, trauma, heart attack, or surgery can lead to diabetic ketoacidosis in such cases.

People with type 2 diabetes usually develop ketoacidosis only under conditions of severe stress. Poor compliance with diet and treatment is usually the cause when episodes are recurrent.

Symptoms

Frequent urination or frequent thirst for a day or more
Fatigue
Nausea
Vomiting
Muscular stiffness or aching
Mental stupor that can progress to coma
Rapid deep breathing
Fruity breath (breath odor)
 

Additional symptoms that may be associated with this disease:

Headache
Consciousness - decreased
Breathing - rapid
Breathing difficulty - lying down
Blood pressure - low
Appetite - loss
Abdominal pain

Our children tend to have diabetic tendencies. When they get sick or stressed in their bodies, they act as a diabetic does and it affects blood sugar as well as the ability to absorb/uptake insulin. This is where doctors need to recognize that our children have a fatty acid metabolism disorder that is also associated with blood sugar levels.

The fastest test to be done at the moment is testing for ketones. This is done by obtaining a small amount of urine. To test for ketones the test is done by placing a small amount of urine on a test stick called a Uristix or Ketostix. You can place a 2x2 of cotton in the diaper over the penis or in the vulva area for girls.  When it has even a small amount of urine on it, you use a 3 cc or 5cc syringe and suck up the urine into the syringe from the cotton 2x2. You can also use a cotton cotton ball that is saturated and squeeze the urine onto the Ketostix.  You do not ever want to see glucose in the urine or ketones. Depending what is going on in the child you might see one or both. If Ketones are present here is how to correct the problem. To correct this problem they need to give an insulin drip. The insulin will then cause the glucose (blood sugar) circulating in his blood to be taken up and utilized by the cells. When they get into a comatose state or comatose like state this is because the brain is not getting fed (glucose/sugar). If the glucose can not be taken up by the cells the body thinks there is no sugar and begins breaking down fat and muscle trying to convert the fat into an energy source. At this point, there is not enough insulin to take the sugar into the cells. If the blood sugar levels are normal, then there is just the sugar circulating in the blood but it is not being taken into the cells. The sugar is just floating around in the blood stream and this is why  you get the comatose state. This can result in neurological complications. IV fluids can be pushed at a rate 1 1/2 times maintenance such as sodium chloride and if required potassium or sodium bicarbonate. Pedialyte and its counterparts are not adequate sources of calories or sugar when our children get into this state.