Version June 2024
| Counseling |
| Discuss seizure reduction, medication, and cognitive expectations |
| Potential psychosocial and financial barriers to the use of KDT |
| Review antiseizure medications and other medications for carbohydrate content |
| Recommend family read parent-oriented KDT information |
| Child life specialist contact in advance of admission, if available |
| Nutritional evaluation |
| Baseline weight, height, and ideal weight for stature |
| Head circumference in infants |
| BMI when appropriate |
| Nutrition intake history: 3-day food record, food preferences, allergies, aversions, and intolerances |
| Establish diet formulation: infant, oral, enteral, or a combination |
| Decision on which diet to begin (classic KD, MCT, MAD, and LGIT) |
| Calculation of calories, fluid, and ketogenic ratio (or percentage of MCT oil or carbohydrates per day) |
| Establish vitamin and mineral supplementation based on dietary reference intake |
| Laboratory evaluation |
| Complete blood count with platelets |
| Electrolytes to include serum bicarbonate, total protein, calcium |
| Serum liver and kidney tests (including albumin, blood urea nitrogen, creatinine) |
| Fasting lipid profile |
| Serum acylcarnitine profile |
| Vitamin D level |
| Urinalysis |
| Antiseizure medication levels (if applicable) |
| Ancillary testing (optional) |
| EEG |
| MRI of brain |
| ECG (strongly consider if history of heart disease) |
| Urine organic acids (if diagnosis unclear) |
| Serum amino acids (if diagnosis unclear) |
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