A diet history and food preferences will be obtained. Blood sugars and ketone levels in the urine are monitored on a regular basis by the nursing staff. The child continues fasting for 24 to 48 hours. These special meals are introduced slowly to accustom the child to the high intake of fat and to allow the ketones to continue to build. Complications of fasting can include low blood sugar, lethargy, nausea and vomiting.
Dehydration also can be a complication.
It is deficient in vitamins and minerals, including calcium. The dietitian teaches the family about weighing foods, planning meals and dealing with problems that may come up with the diet once at home. Seizure medications will not be changed initially. Follow up visits are scheduled at one month, three months, six months and a year. Decisions regarding medication and continuation of the diet are usually made a these times.