ketones - do you test?

[picklebean]

I've been type1 for 20 years and apart from my initial diagnosis where I had DKA I have never tested for ketones. I have struggled with control of my blood sugars for many years and quite regularly find my blood sugar to be 20+. When this happens I take a correction dose of insulin and usually I am back down to safer levels by the end of the day. It does happen quite often though and sometimes whatever I do they don't seem to come down.

Since being a member of the forum i've read a lot about ketones and read about people testing for them at home. Do you think it is something all T1s should have? Do you test at home for ketones when your sugars are high? Would you recommend getting a meter? (I understand you can buy them at chemists).

Your thoughts/opinions are very much appreciated.

 

[petertremelling]

Hi, I have posted elsewhere on the forum that I have just been sent a Glucomen LX plus meter by the makers Menarini. It came free of charge and is capable of measuring both blood glucose and ketones (using different strip of course). The web address is www.glucomen.co.uk and quote the code AD4. The advert is in the current 'Balance' magazine. They do a brilliant software program so you can keep track of your readings. The blood glucose strips are available on prescription, and although the ketone strips have a pip code, you will most likely have to buy these yourself as they cost some 50pence per strip. Hope this helps.

 

[twinkle1980]

I also use the glucomen lx plus l, its what my dsn recommended... I also called glucomen too to register for the batteries, and they also sent me a spare metre and 2 bright silicone covers.

Anyway my dsn explained it was sensible to test for ketones if sugars are high (+14 she said), and warned me that I might have to stamp a bit with the gp to get the strips. Well not only did I not need to stamp, but they prescribed 2 boxes (10 in each box) and put it on my repeats! Not all gp's are cutting back on diabetic supplies.

 

[picklebean]

Thanks both for your input and the helpful info.

That's what i forgot to ask in my initial post.... at what blood sugar level should you start testing for ketones? Is 14 the recommended level?

 

[JConnor]

I also test when blood are high (about 14-15) with glucomen lx and urine sticks. must admit my gp gives me what ever i ask for i got 30 strips at a time and can have them as often as once a week if i need them.

 

[elainechi]

my daughter bs is often in the 20S before dinner but i rarely test for ketones...when shes been unwell i have and phoned the hospital when they were nearly 5....having stomach cramps ...very dry and alittle bit sleepy but they weren.t concerned ....so when does one worry?????....i got told if she loses consciousness bring her to a+e !!!!!.if thay happens its 999 as i cant maintain an airway whilst driving!!!

 

[AMBrennan]

Do you think it is something all T1s should have?

I think all T1 diabetics should have some way to test for ketones; however, it is my opinion that blood testing provides few benefits in typical day-to-day use (to distinguish between DKA and taking insufficient insulin for food - drinking a bottle of Lucozade will give you high BG and won't be good in the long run but it's not a medical emergency).

I would test of ketones if BG was hi but I haven't had any high (>10 mmol/l) readings since leaving hospital so that statement is vacuously true. I got a Optium Xceed meter (Abbot gives them away for free as long as you have been told by a doctor to test BG at least once per day), and get 20 strips on repeat.

..i got told if she loses consciousness bring her to a+e

Ok... I'd suggest that you go find another endo because that's just insane - ignoring DKA until the patient falls in a coma is very very very bad advice :thumbdown:

I'd suggest to go see a doctor if you have persistent high BG with ketones that you cannot bring down (GGC suggests after 3 sick day doses). Go see a doctor in case of persistent vomiting or when you can't keep liquids down.
Go to A&E when classical symptoms appear (hyperventilation aka Kussmaul breathing, rapid heart beat, vomiting).

 

[donnellysdogs]

TBH... No I don't test. Dxd 27 years.. No complications. Hba 6.6.

I do get some high levels but have always been able to lower them and know that equipment, forgetfulness, or something stupid caused rises. I have never had problems like some for illnesses. Only other probs I had were HCPS telling me to take a certain action which really threw my levels horribly high constantly, until I could get them rebalanced... Disnt feel I needed to worry about ketones because I knew cause and just had to rebalance myself..and to make sure I dran more than usual to help my kidneys.

But honest.. I have never tested for ketones..

 

[anna29]

Hi All .
I only test for keytones when I am actually 'ill' sick with an infection, virus, etc.

Both my GP and DSN ask me this question when I attend my diabetes clinics and reveiws .
Give me scripts for the sticks to test and tell me I 'must test' and keep eye on them regularly .

I tend to only test with BG levels of 14.8 and upwards when 'ill' ...
Find it sometimes harder to remember to apply the sick day rules sooner than later also.
Its like I battle things off on my own steam then 'remember' to keytone test and use the
sick day rules 3-4 days later :roll:

Anna.

 

[noblehead]

Only really test for ketones if I'm ill, thankfully I never seem to show ketones in my urine when I test but always keep a box of ketostix in the bathroom just the same, a good tip is to write the date on the box when you first opened the container.

 

[Sarahg]

I would test my ketones regularly when my bloods are high from 14 up. I also test quite a lot when I am sick.

I have been quite sick recently and was reading 4+ of ketones on the keto sticks and when talking o my diabetic nurse I was told to go straight to my local a&e. This has been there response each time I've had ketones when ill.
I highly recommend testing as if your ketones become dangerously high you run the risk of dka as this has happened to me before.

Sent from my GT-S5360 using DCUK Forum mobile app

 

[agold]

Hi. According to my clinic, yes, all t1s should be testing for keytones when bloods are 14 and above, regardless of whether you feel ill or not. I was just told to use the urine strips 'Ketostix' which change colour if keytones present in urine, in which case you should double normal correction dose and keep retesting. The sticks are available on prescription from your gp. i was also told not to exercise if bloods 14 or above as this can cause keytones. Hope that helps.

 

[picklebean]

Thanks all for your input - very interesting reading your responses.

I think I shall be off to the pharmacy to buy a test kit asap. Makes me wonder how at risk I've been all these years without testing... I suppose I'm alive so it could've been worse! :roll:

 

[paul-1976]

I would test my ketones regularly when my bloods are high from 14 up. I also test quite a lot when I am sick.

I have been quite sick recently and was reading 4+ of ketones on the keto sticks and when talking o my diabetic nurse I was told to go straight to my local a&e. This has been there response each time I've had ketones when ill.
I highly recommend testing as if your ketones become dangerously high you run the risk of dka as this has happened to me before.

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Hi!

I've had 4+ ketones recently with a sickness bug but didn't get round to phoning the nurse,what did they do at A&E when you arrived with high ketones? was you admitted after tests or were you allowed home?(Hope you don't mind me asking :wink: )

Many thanks

Paul

 

[donnellysdogs]

I too am very intersted as to what happens when you get to hospital with ketones. I'm the person that has never tested in 27years, no complications... But very rarely above 10 unless I forgot to put on extra tbr after rxtra food.. Or failure with pump equipmentI except for one longterm recently due to hcp advice, I so rarely ever get a 'hi' that I really wouldnt know 100% how long to wait, how many tests, and more importantly what do they do in hospital that cant be done at home ... At home I can give more insulin, I can drink more, I have a cgm.. Just what would they give extra to me at hospital?
I do have ketone blood sticks and meter, just never used.

 

[AMBrennan]

They can do detailed blood tests (e.g. low potassium) and correct them. If you are suffering from nausea, they have drugs to stop you being sick and IV glucose. Plus, the IV probably helps with rehydration.

 

[Sarahg]

when I go in the usually but me on a drip of saline and the will run tests to check for dka . saying this when ive gone into hospital my letones range from 2.5-6 and they become worried when they are higher than one.

They usually end up giving me potassium also as when my ketones are high a get really sick and can't keep anything down. Before I became sick last year I used to not worry about ketones but since then through talking to doctors and nurses I've been advised to go to the hospital just too be sure.

Sent from my GT-S5360 using DCUK Forum mobile app

 

[abs]

If my levels are above 20 I test and when found high level if ketones once went to a&e doctors orders just spent day in there and had bloods etc done. The ketone strips cost a lot of money which I'm guessing is why they are not often given out.

 

[noblehead]

The ketone strips cost a lot of money which I'm guessing is why they are not often given out.

My gp refuses to prescribe ketone strip for my meter and insist the Ketostix are good enough..........and far cheaper!

 

[petertremelling]

Could I just ask what the point of testing is if you don't "get around to calling the nurse"?