Other causes for ketones/higher BG levels in a toddler?

My daughter (non diabetic) was diagnosed with an autoimmune vasculitis condition in April. I’ve checked her blood sugar occasionally since I was diagnosed with LADA, and the only issues we’ve had so far are occasional fasting hypos (50s). Today, however, she complained of being tired while we were out, and as soon as we got home said she wasn’t feeling well. I checked her urine to make sure it wasn’t a flare up of the vasculitis condition, and the only abnormal things were a little protein and mild ketones. I checked her blood sugar - 190. Washed hands really well and checked again - 181. This was just over an hour after I’d given her lunch. The only thing is, she’s not peeing a ton; in fact, the reason I checked her urine at all is because she hadn’t peed in the 4 hours prior, which is unusual for her (she’d just been holding it). My husband did comment he’s noticed her breath smells bad, though he’s not sure if it’s been fruity smelling or not (I can’t smell much due to sinus issues). Her doc has ordered fasting glucose/A1c tests and wants us to call immediately if her BG goes above 250.

I’m just wondering…if she has other health issues going on, can stress on a body cause mild ketones/higher BG levels like this in a toddler?

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