Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension
Open accessAbstract
OBJECTIVE: To compare the frequency of elevated morning blood ketone levels according to age in 4-14 year olds with type 1 diabetes following overnight use of an automated low glucose insulin suspension system, or following control nights when the system was not used. RESEARCH DESIGN AND METHODS: For 28 children ages 4-9 years and 54 youth ages 10-14 years, elevation of morning blood ketone levels was assessed using the Precision Xtra Ketone meter following 1155 and 2345 nights, respectively. Repeated measures logistic regression models were used to compare age groups for blood ketone level elevation following control nights (system not activated) and following intervention nights with and without insulin suspension. RESULTS: Elevated morning blood ketones (≥0.6 mmol/L) were present following 10% of 580 control nights in the 4-9 year olds compared with 2% of 1162 control nights in 10-14 year olds (P < 0.001). Likewise, the frequency was greater following intervention nights in the younger age group (13% of 575 nights vs 2% of 1183 nights, P < 0.001). A longer duration of pump suspension resulted in a higher percentage of mornings with elevated blood ketones in the younger age group (P = 0.002), but not in the older age group (P = 0.63). The presence of elevated morning ketone levels did not progress to ketoacidosis in any subject. CONCLUSIONS: Elevated morning blood ketones are more common in younger children with type 1 diabetes with or without nocturnal insulin suspension. Care providers need to be aware of the differences in ketogenesis in younger age children relative to various clinical situations.
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A prior study reported that younger children aged four to nine years were more sensitive to pump interruption than older children aged 10 to 14 years.
“A prior study did report that younger children aged four to nine years were more sensitive to pump interruption than older children aged 10 to 14 years.24”
From Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion (2024) · cites this paper as [24]
Children, especially younger children four to nine years old, are particularly sensitive to interruption of insulin infusion.
“This could be important because children, especially younger children four to nine years old, are particularly sensitive to interruption of insulin infusion.24”
From Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion (2024) · cites this paper as [24]
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Research works printed but not linked: 17
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Cited by
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Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion
Klonoff, D. C., Ayers, A. T., Ho, C. N., Fabris, C., Villa-Tamayo, M. F., Allen, E., Cengiz, E., Ekhlaspour, L., Wong, J. C., Heineman, L., et al. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968241280386 · Cited by 4 · see citing works
- Authors
- Wadwa, R. P., Chase, H. P., Raghinaru, D., Buckingham, B. A., Hramiak, I., Maahs, D. M., Messer, L., Ly, T., Aye, T., Clinton, P., Kollman, C., Beck, R. W., Lum, J., & for the In Home Closed Loop Study Group
- Affiliations
- University of Colorado Anschutz (US)
- Jaeb Center for Health Research (US)
- Stanford Medicine (US)
- St Joseph's Health Care (CA)
- Corresponding author
- Lum, John
- ORCID
- Venue
- Pediatric Diabetes
- Publisher
- Wiley
- Published
- 2016-07-12
- Volume
- 18
- Issue
- 6
- Pages
- 422-427
- ISSN
- 1399-543X (ISSN-L)
- PMC
- PMC5233607
- OpenAlex
- W2493910315
- Cited by
- 13
- References
- 0
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2018: 1
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085591)
- JDRF (22-2013-266)
- JDRF Canadian Clinical Trial Network (CCTN) (JDRF # 80-2010-585)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, children, blood ketones, ketosis, artificial pancreas, age differences, ketogenesis, diabetic ketoacidosis, insulin pump therapy
- MeSH terms
- Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Ketones, Male
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