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What is ketosis in children?
Ketosis in children (also called acetonemia or ketoacidosis) is a disorder that exists when glucose reserves run out and body burns fat.
Acetone is produced in small amounts during the normal metabolic process and expelled from the body through breathing.
The body increases the acetone content in some situations, namely when the energy requirement is increased, such as:
- in pregnant women,
- in newborns, even if they are breastfed,
- in children up to about 12 years of age, but mainly between 2 and 10 years.
The body produces acetone during fat splitting, so much more acetone is produced when a low-carbohydrate diet is followed.
Formation of acetone and keto bodies
When the sugar reserves in the blood are depleted, the liver produces energy through the oxidation (chemical reaction) of the fatty acids.
This process produces keto bodies:
- Acetoacetic acid
- beta-hydroxybutyric acid,
- Acetone.
The first two enter the bloodstream and are used to produce energy for the organs, such as:
- Brain
- Heart
- Nephritic
- Brawn.
The brain can only use the glucose and keto bodies as an energy source.
When the keto bodies accumulate in the blood, they are excreted through the urine.
The acetone is released through breathing and causes a fruity breath.
Ketosis occurs:
- in case of excessive production of keto bodies,
- if the body is unable to dispose of these substances.
Ketosis in children with diabetes
Type I diabetes (or juvenile diabetes) affects children and is characterized by too low an amount of insulin in the blood.
Under these conditions, the cells must consume stored fats for energy.
The decomposition of fats leads to an excessive amount of acetone. The result is ketosis in children with diabetes.
Causes of acetonemia in children
- Metabolic diseases such as diabetes mellitus (types 1 and 2) can cause ketoacidosis.
- During extreme hunger, the body’s carbohydrate stores drain and the body begins to break down fats into ketones.
If a child has no appetite due to illness or consumes a lot of calories because it has a fever, the body uses the fats to gain the necessary energy.
Other causes of ketosis:
- Pregnancy
- Fast
- Alcoholism
- Liver diseases
- Gastroenteritis (stomach flu)
- Fever
- intensive and prolonged stress
- Poisoning by ethyl alcohol
If diseases have been excluded, this means in the case of acetonemia of the child that the diet is not correct.
Today we speak of ketogenic diet, a high-protein diet that allows you to lose weight quickly.
If the child often suffers from persistent ketosis, it consumes too many proteins, i.e. an excess of:
- Meat
- Fish
- Wobble
- Dairy products.
Symptoms of acetonemia in children
Ketosis is a common disorder in children.
Mild ketosis leads to the following symptoms:
- fruity breath
- Vomit
- Headache
- Speech disorders
- Sleepiness
- Lethargy
- dry mouth and bitter taste
- white tongue
Rare symptoms of severe ketosis may include:
1. change in state of consciousness,
2. deep drowsiness.
Signs of diabetogenic ketoacidosis – immediate emergency care required in case of:
1. Abdominal pain, also very severe
2. Abdominal cramps
3. Bad breath with fruity or wine or acetone smell
4. Tiredness or lethargy
5. Nausea and vomiting
6. Dehydration
7. Shortness of breath, heavy or rapid breathing
8. Drowsiness, loss
of consciousness 9. Coma 10. severe thirst
11. frequent urine excretion (polyuria)
Diagnosis of ketosis in children
Ketosis manifests a symptom that is helpful in diagnosis: the patient’s breath smells of ripe fruit through the ketones present in the blood.
To establish the diagnosis, doctors look for elevated levels of acetone and ketone in the blood, then they assess the physical symptoms.
Examinations for the diagnosis of acetonemia are:
- urine sample to find ketones (usually urine does not contain ketones);
- Blood analysis to control the percentage of ketone in the blood.
Treatment of non-diabetic ketoacidosis
Therapy of ketoacidosis in children consists of:
- Hydration to replace the fluid released during vomiting
- Glucose-rich diet to avoid the formation of further acetone.
There are different views on the use of antacids.
Treatment of diabetic ketoacidosis
In case of diagnosis of diabetic ketoacidosis, the child must be hospitalized by an emergency doctor or in a hospital.
The therapy consists of a threefold approach:
Hydration
It is important to provide fluid to the body, either by drinking or by infusions, until the patient is sufficiently hydrated.
The fluids need to replace those lost to the body through excessive urination, and they help dilute the excess ketone in the blood.
Electrolyte substitution
Electrolytes are minerals that carry an electrical charge, for example:
- Sodium
- Magnesium
- Potassium
- Chloride.
Insulin deficiency can lower the level of various electrolytes in the blood.
Intravenous electrolyte delivery allows the heart, muscles and nerve cells to function correctly.
Insulin therapy
The causes of diabetic ketoacidosis are corrected by insulin.
Along with fluids and electrolytes, the doctor makes an insulin injection to raise this hormone level in the blood again.
Once blood sugar drops below 240 mg/dl, you can:
- discontinued intravenous treatment,
- normal subcutaneous insulin treatment should be continued.
Once the blood composition has returned to normal, the doctor needs to find out what caused this event of diabetic ketoacidosis.
Depending on the circumstances, further treatment may be required.
For example:
- In the case of diabetes that has not yet been diagnosed, the doctor will help you to properly adjust your diabetes.
- If the doctor suspects a bacterial infection as the cause, he can prescribe antibiotics.
- If the cause of ketosis is a heart attack, the doctor will recommend a cardiological examination.
Natural remedies for non-diabetogenic ketoacidosis
If the child has acetone due to lack of sugar in the blood, he should drink liquids with simple sugars, which are quickly absorbed into the blood.
It could, for example, drink fruit juice.
How long does ketosis last in children?
If the excessive production of acetone is not due to diseases, then with an adequate diet, the symptoms usually pass after 2-3 days.
Prevention of diabetic ketosis
In the case of diabetes or other metabolic diseases, it is necessary to follow the doctor’s instructions regarding:
- Nutrition
- Medicines
- Lifestyle.
If changed symptoms occur, you should contact the doctor immediately.
In this way, internal sources of acetone formation can be kept under control.
What can children with ketosis eat?
Children and infants with type I diabetes must follow an appropriate diet that limits sugary foods that can raise blood sugar.
Calories from carbohydrates should make up about 40-60% of the diet. This limit should not be exceeded.
Among the foods allowed by the doctor are whole grains (pasta, rice or bread) instead of refined flour, because this avoids blood sugar spikes.
Legumes have a lower glycemic index than cereals, so they are more suitable for diabetics.
Diet and nutrition for ketosis
To solve the problem of ketosis in children and adults, conventional medicine recommends a balanced diet.
Fatty foods should be reduced, such as:
- Whole milk
- Butter
- Cheese
- Fried
- Chocolate
- Sausages.
According to the natural medicine of Lezaeta and hygienism, this disorder is caused by an excess of:
- animal proteins (meat, fish, dairy products and eggs),
- processed and preserved products,
- Cooking the food.
Ketosis in children thus passes through a diet based on:
- Vegetable
- seasonal fruit,
- Nuts.
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