Remember these? Why don’t they make them anymore? I have a bottle of 50 Relion Ketone strips if I really needed them, but whenever I’ve wondered if I should check for ketones, I always hesitate, because opening up the bottle means they’ll only be good for the next 6 months. I’d never use 50 in a 6 month period. Seems so wasteful, and a way to sell more. What are your thoughts?
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I use the strips beyond six months and they seem to work fine for me… (But I also use a blood ketone meter so can double-check if I doubt the results.) The foil strips would make more sense, though.
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I think it’s ridiculous. If I opened a ketostix container, I would just do more ketone testing and use them up before the 6 month expire. Maybe even do more than one test and see if they have the variance range like our bg strips do. At least those ketone strips are not real expensive, right !?!
If I were you, I’d get a blood ketone meter. You can get one free of charge by calling the company that produces the blood ketone meter, as they know they make their money from test strips and are more than happy to send a free meter your way! Blood ketone readings are much more accurate; urine ketone measurements reflect what your ketone levels were a few hours or so ago, while blood ketone measurements are significantly more “current”. And blood ketone strips are individually foil wrapped, so no issues with a whole bottle of strips going bad.
I second this. The blood strips are more expensive, but since you hopefully don’t use them often, it’s not too bad. Plus, I like having a number rather than trying to guess at colours. And, as @rgcainmd, the number is “current” so it makes it much easier to monitor for changes.
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i have a meter that uses blood ketone strips that are foil wraped but when i try to get some from a chemist most of the time they are already passed the use by date and the idiot’s say or that doesnt mater so i stick with ketodiastick or ketodiabur strips and keep using the melted yellow snow on them although i do wonder wether there is a renal threshold for ketones as there is for glucose…
@jojeegirl mentions a ketone threshold in this post. As to what that threshold actually is, I don’t know, but maybe she does (or maybe Google does!).
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@Jen, Hi Jen, The ketone threshold essentially is the point at which one detects ketone bodies in one’s urine.
As you are likely aware, during time of illness/infection, when your BG is > 250 (if one is a person with T1DM) and that individual is are dealing with stress…that person should check for ketones in their urine.
Because everyone is different it could be that one’s ketone threshold is < 250. Everyone’s body type, metabolism, diet and hydration status are so very different and unique to him/her that the fuel the body utilizes at any moment and how the body stores circulating glucose (especially with T1DM) is variable.
It’s about the individual understanding all the nuances of who he/she is so intimately (as it pertains to glucose metabolism) that one understands the many variables that increases one’s risk of DKA.
If I might use an analogy, (and I am not at all minimizing the challenges living with diabetes poses) one can think of the threshold like the blood alcohol content. At one threshold one is under the influence and the other one is intoxicated. Too, variables such as one’s weight play a huge role on BAC. Further, the consequences of being one, 2 or three times over the limit can be quite serious as can the presence of moderate or large amounts of ketone in the urine (concentrations > 0.6 mmol/L) as they are suggestive of impending DKA
Thank you for your question. I hope my response is helpful.
Be well.
I thought that the ketone threshold might be like the glucose threshold, where glucose appears in the urine once it rises above 160-180 in the blood. I was thinking there was a certain level of blood ketones that, once it was exceeded, ketones would appear in the urine as the body tried to get rid of them.
@Jen, very similar. Good analogy. The operative word is “threshold.” Sort of an area of demarcation that identifies an impending outcome (i.e. carrying the bride over the marriage threshold. Here the impending outcome related to that (When the groom carries the bride over the threshold, he is reenacting a very old tradition derived from many cultures, and one which can be traced to Roman times. This ritual was carried out to protect the bride from worrisome demons which might be lurking about the new home. If she were to trip entering the doorway, it would bring bad luck to the couple. This unhappy chance was avoided by carrying her through the doorway and over the threshold).
All my life I thought it meant something else. 8))
On another note…Glucose is always present in the blood. There are thresholds for hypo/hyperglycemia, thresholds for hypertension, thresholds for prediabetes etc. etc. etc.
Your last sentences refers to “spillage” which occurs when one is hyperglycemic and glucose is excreted in the urine as well as ketone bodies. Hence, a persons BG levels as he/she approaches hyperglycemia should act at a threshold to determine at what level one is using fat as a fuel source and thus producing (from a metabolic perspective) ketone.
This is a very basic explanation, that I hope is helpful to you. I do think you would find it very interesting (if you have not yet done it) to look up glucose metabolism. It’s one of my favorite things to study. Khan Academy does a wonderful video on the Krebs Cycle.
I hope you have time to listen to it and find it helpful in understanding glucose metabolism.
Be well.
Is there an actual numerical threshold at which the body decides it has too many ketones and starts trying to get rid of them in the urine? I don’t know if blood sugar would be related to it, but other things might.
My blood sugar can be 600 if I eat half a pizza and forget to bolus for it, yet I’ll have no ketones because I have my basal insulin and my cells are able to access glucose and aren’t starving. Yet, if my pump becomes disconnected, I’ll get ketones after only a few hours even if I don’t eat anything and my blood sugar only rises to 300. So you can spill glucose and not spill ketones. Or, someone on a very low carbohydrate diet might spill ketones but not spill glucose.
I was just wondering if, like glucose, there was a known number (or range) after which the body start spilling ketones.
I’m on spring break so will look this stuff up on Khan Academy. I didn’t think they did anything other than math. 
Blood ketone testing is where it’s at… I have a precision neo from Europe (since the ones they sell in the US don’t test ketones) and that meter is nearly FLAT, so it’s super easy to keep in my kit and not make it any bulkier
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@Jen I love that Khan Academy! Jen I try so hard to give information that is far away from advice. Please know this as I respond.
I think it is important for all to know that the National Board of Certified Diabetes Educators (as part of it’s guidelines) states that all certified diabetes educators must work within their professional scope of practice. As a clinician I am a registered clinical exercise physiologist, CDE,health educator and wellness. So in my role as a CDE I stay in my wheelhouse. I feel safest there.
You should know that it is not safe for anyone to give you advice over the internet or even face to face especially if they haven’t undertaken an assessment. If that person does, she/he is simply guessing and for me that is #NOBUENO.
Regarding the science pertaining to ketones the science says ketone levels greater than 0.6 is when you should start treating the cause of ketosis. (One really want to try to avoid getting there but stuff like LIFE happens and throws a wrench into day-to-day management of diabetes).
Regarding the science, the science says at BG thresholds of >250 mg dl are laboratory indicators of DKA among other things like hydration status, electrolyte imbalance, acidosis which is evident in with one’s respiration. No need for me to say it, however, this is why checking BG, on the regular, is so very important.
And yes, you can spill glucose and not ketone. Great point! This has everything to do with what fuel source the body is using when we are up and active as opposed to fast asleep.When you visit Khan Academy look up RER (respiratory exchange ratio). It’s really interesting stuff.
I suggest you read/research the above as I am not in a position to give advice. But I can help you find the information.
Also look up anaerobic glycolysis, aerobic glycolysis and beta-oxidation. It’s really important stuff I believe PWD should know and understand.
Jen, it really sounds like you know what precipitates ketosuria.
What I am at liberty to say and this is within my scope of practice is, I encourage you to continue to reduce your risk for ketonuria. Continue to protect your kidneys. The glucose and ketones must pass your kidneys in order for your to determine that you have ketones.
I hope this post is helpful to you.
Thanks so much or the interchange and for sharing yourself with me.
Be well.
Thanks so much. I’ll look these topics up. I went on Khan Academy tonight but got distracted with other topics. It’s a great site!
I am not asking for advice so much as this type of informaiton, just out of interest. My post-secondary degrees are in English and education, so I am trying to broaden my knowledge of all science, but especially things related to health issues that I have. Not necessarily so they will help me directly, just out of interest. For example, I have many issues with allergies and have several autoimmune conditions, so I’ve been reading up on how the immune system works, exactly what goes on during allergic reactions and autoimmune attacks, and so on. All very interesting stuff!
And don’t worry, the examples I gave were only examples! I can’t eat pizza (and if I could, I wouldn’t eat half a pizza!), so I am not driving my blood sugar up to those types of levels on purpose. 
Though, as you said, it does happen at times—today I went up to 18 mmol/L after lunch, and I am no stranger to pump and infusion set issues.
@Sarah28 you are so correct. The science says that the level of acetoacetate in the urine is influenced by one’s hydration level and may lag a couple of hours behind blood ketone levels. Thus, urine ketone tests are not reliable for diagnosing or monitoring treatment of ketoacidosis.
Thanks for sharing!
This is also the meter I have in my little backup kit that I bring with me. It’s also much easier to test blood ketones while away from home than it is to test for urine ketones.
I just used that meter this morning, in fact. I went to bed in range but woke up at 5:00 am and corrected a 17 (somehow missed my high alert which had gone off several hours earlier) with 5.5 unis of insulin but continued steadily upwards until I was 22 when I woke up again two hours later. Definitely a handy thing to have!