Each diabetic handles their/their child's ketones differently, based on what their doctors have them do.
Lenny's endocrinologists advise us to do the following, and this is how we handle ketones.
For trace and small ketones, we simply push the fluids. The more fluids, the better! Fluids help flush out trace and small ketones, usually with little need for help from other sources.
For moderate and large ketones, we typically give him a little extra insulin and push fluids. For Lenny, I give him about half a unit extra insulin than what his pump tells me to give him for the accompanying high plus whatever carbs he has eaten/drank. That extra half a unit of insulin is usually enough for him to work out the ketones. Not always though! If he is sick and has a fever, sometimes it can take multiple tries of this technique to work, and sometimes we have to continue to do this, plus push fluids, plus put him on an increased temp basal, in order to knock out the ketones. Usually, for Lenny, ketones are only this persistant when he is very sick.
If he is not sick, and he has high blood sugars, and large ketones, usually giving him a little extra insulin plus pushing fluids, will knock out the ketones within a matter of 2 hours or less.
It is important to remember that every diabetic is different. What works for us, may or may not work for you or your child. Before trying something new, always talk to your endocrinologist and get their opinion on the situation! I can not stress that enough!
Ketones can be scary, especially when they are large and/or last for several hours. Remember to stay in contact with your Diabetes Educator or Endocrinologist if you have ketones, and follow their instructions. If ketones are left untreated, they can cause a person with diabetes to go into what is called DKA (Diabetic Ketoacidosis). DKA can be life threatening! Be sure that if you test poistive for ketones, to test your blood sugar every 2 hours, and test your ketones every 2-3 hours (and anytime your blood sugar is over 240), until a negative ketone test appears.