I usually buy a container of the ketone urine test strips once a year just to have on hand if I get sick or something. I had a bad infusion site yesterday while I was very busy (and ignoring my pump and BG), and I ended up having a very high BG. I tested for ketones, and I was showing some. This alarmed me. I know to drink a lot of water, which I did, and I did not eat carbs until everything settled down. (I called the endo on call too.)
Anyway, in googling I found that there are ketone test kits much like glucometers. Does anyone have one they would recommend?
Interested in knowing why you are testing that.
I do urine ketones when I am fasting just to make sure it doesn’t get too high. But I have a constant flow of insulin on my pump. That normally prevents DKA and with a cgm, I don’t worry so much about ketones.
In the past it was so fleeting anyway I never saw a reason to be testing them. The few times I was in DKA there was absolutely no doubt. I felt horrible. I know that feeling. But that was before I have cgm, and once my pump set came out. The other time I was exercising too much and dehydrated and I was injecting insulin, and I think I wasn’t taking enough.
For my urine I like to see 2 + or 3+ ketones when I’m fasting. Once I eat, that vanishes to trace in less than an hour.
Small traces of ketones are normal for everyone. I just wonder why a blood monitor is needed since I think I could tell I needed to do something before it would show in a test
I have a Precision Xtra ketone monitor (it may also do BG, not sure) but only because I’m currently in a clinical trial for something and part of that is testing blood ketones if my BG has been over a certain number for a certain period of time.
I wear a pump and CGM and I am very aware of when something isn’t working. I have no problem using my BG meter to test if I suspect my Dexcom is off (and I also test a lot during the first day of a new sensor) or if I think my infusion set isn’t working. I am not worried about going into DKA. I will not spend money on strips for a ketone meter and hate buying the urine strips. If they sold those in a vial of 10 maybe, but buying 50 when I may possibly need to use it once is a waste.
I also have Precision xtra. The meter can test BG or ketones ( uses different foil packed strips). Even though I’m 100% on CGM I carry this meter when traveling with both types of strips “just in case”. I’ve only tested for ketones a handful of times, when a bad pod site has caused lack of insulin and high BG for hours and hours.
I think having a ketone meter on hand snd testing when worried is a good thing to do. When my BG is going rogue a ketone test has given me good peace of mind, more than once.
I’ve used the Precision Xtra blood ketone meter for many years now. Its primary importance to me is to detect when I am under a serious threat of DKA.
DKA occurs because of an interruption of insulin delivery and absolute level of BG is not a reliable detector. This makes the accurate detection of high ketone levels especially important.
I treat my diabetes with an insulin pump. A kinked cannula, a disconnected infusion set, or even just impaired insulin absorption can lead to DKA.
A few years back, I woke up with BGs 250+ and feeling nauseated. I tested my ketones and found them higher than usual. I immediately took action. I took a corrective insulin dose via a syringe and changed my infusion set and site. I drank plenty of water. My preemptive action averted a hospital visit, I’m sure. I was likely within hours of serious trouble.
While I primarily use my blood ketone meter to confirm my ketosis from my low carbohydrate way of eating, the ability to manage emergent DKA is priceless. I live alone.
I rarely test for ketones because my time in range and A1Cs are very good. I end up tossing the urine strips each year, which I guess isn’t a big deal, but I thought the blood tests were more accurate and the strips lasted longer. I may be wrong.
This happened just because I was busy and distracted and assuming the alerts on my pump were okay. I could see I was rising and supposedly getting microdoses of insulin. By the time I realized I must have a bad site, my BG was over 300. It really scared me, and I felt horrid.
I’ve had type 1 since 1967 and consider myself very fortunate that I rarely have had to test for ketones. I should have taken five minutes to see what was actually happening and actually check the infusion site rather than assume I was getting the insulin.
@Jaye2, If I’m feeling well and BGs are at expected levels, I test ketones a few times per month to confirm nutritional ketosis. If I feel sick, especially if nauseated, I test ASAP. I am committed to always keep a supply of blood ketone strips on-hand.
I agree with you about the quantity of strips. So many just end up unused in the garbage. I suppose the blood strips would be the same. Thanks for your input.
I also use Precision Xtra. Got it during a clinical trial a few years ago. Love the fact the strips are foiled wrapped vs the urine strips that are in a tube that you will never use in a year.
What is the treatment for keytones for T1D’s, other than taking insulin? And if it’s to just take insulin, why would testing for keytones add useful info which testing for glucose level doesn’t already provide? Genuinely curious/confused
@BKN480 – Ketones are often present in the blood of healthy people. Low levels of ketones are common during sleep. It is high levels of ketones that lead to DKA.
When ketones are too high for too long, the risk of DKA, a potentially lethal circumstance, is higher. A person, including diabetics, can have any level of glucose and suffer DKA. Doctors even have name for normal glucose DKA, euglycemic DKA.
On the flip side, the blood glucose can be very high with normal levels of ketones.
Therefore, testing ketones independent of glucose is a critical survival tactic for diabetics. Treating DKA in its early stages is much easier and more successful. Later stages of DKA involve critical electrolyte and ph balance (hospital ICU required) that is beyond my knowledge but I know that management of ketones demands respect.
High ketone levels in an insulin-dependent diabetic means insulin delivery has been interrupted. Restoring insulin delivery is how to start treating DKA; more advanced DKA needs hospital ICU tactics and knowledge. This is especially true for those of us who use insulin pumps.
“High ketone levels in an insulin-dependent diabetic means insulin delivery has been interrupted.” But wouldn’t this be indicated by high, or at least persistently high, glucose levels, which one would want to treat (thereby treating the ketones anyway)?
“A person, including diabetics, can have any level of glucose and suffer DKA.” Ah I see–so to clarify my understanding: knowing ketones independent of glucose level is useful for treatment purposes b/c there can be instances when glucose levels are not significantly elevated, but ketones are high? (But then would giving insulin risk a low?) (I also wonder how non-hyperglycemic and for how long, can glucose levels be and a person can still suffer ketones? Perhaps if they’re constantly 150 for days on end, for ex.? Or is even that low risk for ketones? Perhaps depends on activity level? etc.). Anyway thanks again!
I e never had high ketones when my glucose is normal except then I fast and then it never goes above 2+.
I can feel ketones over that. And one bit of carb will kill the ketones immediately. I only take enough insulin to battle sugars. But again I have never experienced DKA with sugars under 200
DKA incidence with normal blood sugar levels is a listed side effect of the SGLT2 inhibitor drugs such as Jardiance, Invokana or Farxiga. These drugs act on the kidneys to excrete glucose at lower levels than the kidneys would otherwise. One of the published warnings is to be aware of euglycemic DKA. These drugs are indicated for T2D but some T1Ds use them off-label.
What does it feel like to you, just curious? How do carbs kill them?
When your glucose was over 200 and you tested for ketones and saw they were too high, did you do anything different as far as treatment that you wouldn’t have done if you’d just known what your glucose number was (and hadn’t checked for ketones)?
@Terry4 Just wanted to drop a compliment on your concise and clear descriptions of ketones/DKA. Those paragraphs are destined for the TuD hall of fame…Thanks!
Not that’s the reason I usually don’t bother w ketone testing because it doesn’t change what I do to correct sugars.
What I mean about ketones and carbs is. Thst when I’m fasting my body move into distort ketosis so I’m burning defat with no carbs available, but as soon as I eat carbs I quickly switch to back to burning carbs and the ketones go away fast.
This is different from keto acidosis which not only is dangerous but also causes insulin resistance and all the other nasty side effects
