After struggling through Saturday evening with keytones, we put Thomas to bed in the 300's, with keytones going down. At 9:30 things looked good, with a number nicely in range. He needed a correction (by injection) again at 11:30, but the keytones were still low. I kept the temp basal up for another hour, just to see if I could keep the keytones at bay for good.
Tom checked at 12:30 - great number -165, but he didn't check the keytones. Why, you ask, did Tom not check the keytones when the whole problem has been keytones, not BG numbers? Yeah, I don't know either.
4 AM...BG is 59 (How! Did it get. So. Low). Keytones are 1.2 (What?!?! His BG is 59). UGH.
So Thomas was treated to a 4 AM gatorade to bring the BG up (97 by 4:30, with keytones down to .5), followed by a 4:30 yogurt drinkable and an injection to cover/bring the keytones down. Assisted by a 2 hour increase in the temporary basal rate. I was treated to a few waking hours from 4 - 6 making sure I didn't kill my kid with insulin. Oh wait, that's not a treat.
7:45 AM - BG 114, Keytones 0.1. Ahhhhhhhh.
Hopefully we can stay more on track today.
If there is an upside here, I suppose it is that the whole keytone situation is easier to manage with the pump. Certainly there is no way to do a temp basal rate without the pump, and with MDI there would be ongoing concern about the IOB from a long-acting insulin. Of course, the 'freedom' of the pump seems to be what is getting us into this keytone trouble in the first place, but that just might be a whole separate post.