Red: The Color of Passion… Not Ketones

Red is the color of passion, love, and strength. But for families living with Type 1 Diabetes (T1D), red can also mean something very different—and very scary.

When you live with T1D, diabetes is not just counting carbs and giving insulin. Those are important parts, but there is so much more happening behind the scenes. One of the most critical—and often misunderstood—parts of Type 1 Diabetes management is ketones.

What Are Ketones?

Ketones are acids that form in the blood when the body does not have enough insulin to use glucose for energy. When this happens, the body starts breaking down fat instead, producing ketones as a byproduct.

Small amounts of ketones can sometimes appear during illness or dehydration, but moderate to large ketones are dangerous. If ketones continue to build up, they can lead to diabetic ketoacidosis (DKA), a life‑threatening emergency.

What Happens When Ketones Are in the Blood?

When ketones rise:

• Blood becomes more acidic

• The body becomes dehydrated

• Blood sugar levels often stay high despite correction doses

• Symptoms may include stomach pain, nausea, vomiting, fatigue, and rapid breathing

This is why ketones must be taken very seriously, especially in children.

How Do You Test for Ketones?

Ketones can be checked using:

• Urine ketone test strips

• Blood ketone meters

  
  

Most families are familiar with urine strips—the ones that change color. Light pink can signal small ketones, but when that strip turns dark red or purple, it means large ketones and immediate action is needed.

I have many stories of watching a ketone test strip turn dark red for my son. Each time, that color brings fear, urgency, and a reminder that even when you think you’re doing everything right, T1D can still throw surprises at you.

Our Story: December 2021

One story that will always stay with me happened in December of 2021. At that time, we were still very new to navigating life with Type 1 Diabetes.

My son was just 3 years old.

He started showing flu‑ or cold‑like symptoms. His blood sugar climbed over 300 mg/dL, he was on multiple daily injections MDI at the time, and no matter how many correction boluses we gave, it just wouldn’t come down. Hour after hour passed, and the day felt overwhelming and confusing.

After about six hours, he started complaining that his stomach hurt. That’s when we contacted his endocrinologist.

We were told to:

• Check for ketones

• Push fluids to keep him hydrated

• Continue monitoring his blood sugar closely

We followed every direction. But after a few hours, there was no improvement. His ketone strip showed large ketones. He felt even worse and started to vomit.

I contacted the endocrinologist again, and at that point, they told us what no parent wants to hear but absolutely needs to hear: ➡️ “Take him to the ER.”

That night, we ended up in the emergency room. My son was diagnosed with ketosis. Thankfully, it was quickly treated with a cocktail of IV fluids and dextrose, and once his blood glucose levels stabilized, we were able to go home.

But those hours? Those moments of uncertainty, fear, and helplessness—they stay with you.

Why This Is So Scary

Moments like this are terrifying, because even when you are:

• Counting carbs

• Giving insulin

• Checking blood sugar

• Following medical advice

Sometimes, it still isn’t enough.

Type 1 Diabetes doesn’t pause. It doesn’t care how prepared you are or how hard you’re trying. And as parents, that reality can feel devastating.

Why I’m Sharing This

I’m sharing this story because ketones are not talked about enough—especially in the early days of diagnosis. Families need to understand what to watch for, when to act, and when to ask for help.

This is just one story. There are many more, and I’ll continue to share them in future publications.

If you are a parent navigating T1D, please know:

• You are not failing

• You are not alone

• And asking for help can save your child’s life

  
  

Red is the color of passion. But in our world, when that ketone strip turns red, it’s a reminder to act fast—and to lean on the medical team and community that support us.