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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Suffering With Diabetes, Has Difficulty In Passing Urine, Trace Of Ketones. What Does This Imply?

Hi, my 7 yr. old son is a type 1 diabetic. He woke up this a.m. with a bg of 64. Since then, his bgs all day have been between 289 and 399 at school. When he got home he had trace ketones , but had a REALLY hard time peeing. I was there. It came out in fits and starts and he was grunting with the effort of pushing out the urine . I m not sure if the two issues are related, but I m putting them in because they are both unusual occurrences. So, 2 questions: First, what would cause this medium pain (his words) and physical difficulty when peeing &, second, do I need to worry about ketone build-up if he s having a hard time urinating? Thank you.
Wed, 6 Feb 2013
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Endocrinologist,  's  Response
Dear Elf

Difficulty in urination can be because of stricture of the urethra. I would advice you not to ignore the problem and consult your doctor ASAP. Problems with urination can cause fluctuation of sugars and yes in a way they are interrelated.

I would also advice you to get done a serum creatinine to check the kidney status..

I would like to know what were his sugars when the ketone was found in the urine. If the ketone was present with low blood sugar it suggests a starvation state and if it was with high sugars it suggests a diabetic ketoacidosis, in either case we do have to keep a close watch on your child.

I would suggest you to get a blood ketone levels done to get an unbiased picture of the ketone status. Please do blood sugar monitoring atleast 6 times a day during this period. Keep him well hydrated and feed him properly.

All in all dont ignore this issue, please consult a nearby doctor ASAP

Regards
Dr. Om Lakhani
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Child Suffering With Diabetes, Has Difficulty In Passing Urine, Trace Of Ketones. What Does This Imply?

Dear Elf Difficulty in urination can be because of stricture of the urethra. I would advice you not to ignore the problem and consult your doctor ASAP. Problems with urination can cause fluctuation of sugars and yes in a way they are interrelated. I would also advice you to get done a serum creatinine to check the kidney status.. I would like to know what were his sugars when the ketone was found in the urine. If the ketone was present with low blood sugar it suggests a starvation state and if it was with high sugars it suggests a diabetic ketoacidosis, in either case we do have to keep a close watch on your child. I would suggest you to get a blood ketone levels done to get an unbiased picture of the ketone status. Please do blood sugar monitoring atleast 6 times a day during this period. Keep him well hydrated and feed him properly. All in all dont ignore this issue, please consult a nearby doctor ASAP Regards Dr. Om Lakhani