# Ketones, highs and school



## Lynna (May 13, 2014)

At what stage do you send your child back to school after ketones?
My daughter woke with ketones at 1.8 this morning and we have managed to get them down to 0.8 and hopefully will continue to fall. I am going to send her to school as I am concerned at how much school she misses (mostly due to diabetes!). Does anyone think this is too early? Should the ketones be cleared completely? 
(We have done a pen correction and cannula change)
She is feeling ok, a bit tired, but that could be because if disturbed night testing.

Thanks


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## Northerner (May 13, 2014)

Well, I'm not a parent but I think it should be fine if you have corrected the cause and reduced ketones below 1.0 - hopefully some parents will be along to give their perspective though! I hope she is OK and has a good day


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## Sally71 (May 13, 2014)

I think that would be perfectly alright!  We had this problem once on a school day, nurse told me to keep my daughter at home until ketones had returned to normal, i.e. less than 0.6.  Daughter was not impressed as she felt ok (although later admitted that she had a headache), and I was also concerned about missing school.  We reached the desired level fairly quickly and she was at school only an hour late.

I have had ketones a few times though and can now confidently sort it out without needing to call the DSN, and if it happens again to be honest I think I would just send her to school as normal (after changing cannula and doing pen correction of course) and I don't see why extra tests can't just be done at school to confirm that everything is coming down again.  I've never had a case of the ketones not coming down once you get some insulin in.  So the problem would be discovered and corrected by 8 am, we normally arrive at school just before 9 so do another test then, then could leave ketone meter there with instructions for teacher to test again at morning break time, or I could pop in and do it.

If your daughter is only feeling tired and is not feeling ill/being sick then I can't see any problem with this plan, would school notify you if her condition deteriorated?

Hope that helps


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## HOBIE (May 13, 2014)

Hope school went ok


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## Lynna (May 13, 2014)

Hi All 
Thanks for the replys. 
She went to school and was fine. 
I know the DSNs are not keen on going to school with ketones, but I wasn't sure what level was acceptable. 
She has come home and had a couple of hypos though! All over the place at the moment. Thought control was meant to be easier on a pump!!


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## trophywench (May 14, 2014)

It might be when you get it sorted, it's just like being newly diagnosed again though!

Once you get there control is better for more of the time - but you know whoever told you it was easy? - they were lying and have quite obviously never had to blooming well do it 24/24/365/365 ad infinitum without time off for good behaviour.

Have they?


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## Lynna (May 14, 2014)

thanks trophywench! Not really sure what to do to get better control. Think we have it cracked one day then levels go through the roof or the floor and we dont seem to have done anything different! Not sure how long to leave things before adjusting basals ie is it an anomaly or is it a trend. It is not an exact science!!


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