Which Ketone Meter should I get? Any suggestions or reviews appreciated

I would like to get a ketone meter but not sure which one. Years ago I tried 2 different NovaMax ketone meters and they both constantly gave me error messages so I gave up and went back to the urine ketone strips. I’m hoping the ketone meters have improved.

This would depend on how often and why you are testing your ketones. If your experience with meter testing results in errors, probably the strips are a better choice. If I needed to test for ketones, I’d just use the strips for that (hopefully) rare need. Maybe your health care crew can direct you to the best option for your needs.

I’ve always had good luck with Abbott meters (Precision Xtra, Precision Neo).

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Both meters also test blood glucose, so you wouldn’t need a separate meter for ketone testing.

This might sound ignorant, but I’ve always been curious - what does testing for ketones do? Diabetes educators and nurses have always insisted I should have a meter that can test for ketones (I’ve never had an endo talk about this). I don’t really understand what testing for them would tell me. If my blood sugar is high I take insulin to bring it down. How would knowing I have ketones and how many change my course of action?

I think the U.S. version of precision neo does not do ketones.

Checking ketones is a diagnostic tool. If your ketones are high it could be a sign that your insulin is not working properly. For instance if you are on a pump and an kink or something occurs where you are not getting your basal doses then you can quickly go into DKA which is life threatening. If you were to check your ketones and they were high and your BG is high then that would be a reason to go to the hospital or call your Dr.
However if you are on a ketogenic diet this test will not be as useful as you will always have some ketones ( this is referred to as nutritional ketosis). I haven’t checked my ketones since I was a child but if I was feeling certain sypmtoms and my BG was high I would probably check to be safe.

Even when eating a low-carb diet, I check ketones if my BG is high and not coming down and/or if I’m not feeling well. When I’m eating really low-carb my ketone level will be around 0.6 to 0.8 mmol/L usually. When I’ve had a failed pump site, my ketone level has gone to 2.0 mmol/L and above (at which level I feel sick if my BG is high). That’s a level at which I’ll take extra insulin by injection, change my pump site right away, and monitor very closely until my BG and ketones have come down. The main value in testing ketones is that if you have ketones you often require more insulin than you do when you don’t have ketones (a.k.a. “sick day rules”) and they indicate that you may need to seek medical attention if you can’t get BG and ketones to come down.

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If we have high BG (>250 BG) with ketones (medium+) then our Endo has told us to dose appropriately and recheck in 3~4 hrs. If ketones persist (medium or large) then we are directed to at that point call in to our Endo (whatever time it is 24x7).

Same as @Jen and @Tim35. If my BG is high with ketones, I need more insulin to bring it down than if I’m high without ketones. Also, if I get a nasty bug and I’m vomiting, I keep an eye on the ketones. If I can’t bring them down, it’s time to head for the ER.

Thanks for your answer @Jen you are always prompt and supportive when answering questions. If anyone else has experience with ketone meters, I would very much appreciate knowing which ketone meter you use and how your experience of using it has been.

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I’m also interested in a ketone meter. I didn’t know they existed until I saw a review of the top blood glucose meters of 2018 on another thread. One of the top meters is the Fora 6 Connect which also tests for ketones (using different strips). I don’t know if you’ve already made your choice, Yifat, but I’d be curious to know if anyone has experience with the Fora 6. It seems like the cheapest option for a meter that tests ketones.
I’ve used the urine strips in the past, but, on the rare occasions I need them, my bottle has often expired. I suppose I’d have the same problem with a meter, but I like the idea of having a number rather than a color to interpret.

I can’t believe your Endo has not mentioned ketones to you. This is a major concern for all diabetics. I swear by freestyle. We check my daughter with it.

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Not all. I’m a Type 1 and have never had a problem with DKA, so any tiny bit of ketones that I might have (such as when on a low carb diet) are no threat to my welfare. I’ve been T1 since before 1978. oh, and I don’t make any of my own insulin, so I’m about as “pure” a T1 as they come. :slight_smile: Obviously, it is a concern for other diabetics.

I concur, I’ve only tested for ketones once or twice just to see if the meter worked. Still not sure why I ever would test for them.

I have the precision extra, its very accurate. I used it 2 years ago when I was almost in dka with high ketones, my symptoms would have brought me to the hospital, the meter confirmed it. Then I used it while I was there on fluid and the ketones gradually reduced. I carry one in my purse now.

Very high ketones, vomiting, nauseau, stomach pain etc are all symptoms of dka, having a meter can confirm this and let you know you need to go to an er. Taking insulin may not be enough if you’re sick, dehydrated or going into dka for whatever reason, so you then need to go to an er asap for treatment with fluids and treating the illness. Dka is very serious and should not be taken lightly, you can easily die even if you think you have things under control.

We have had difficulties with highs at night for our daughter. We check ketones so we know how much additional insulin she needs. We have checked alot since the pump

I am looking into different ketone meters at the moment as well. Are there any new meters by now or recommendations of people who are happy with their ketone meter? Would love to learn a bit more about the different options.

@Sandra_B we switched from Precision Xtra to NovaMax when my daughter’s insurance stopped covering blood ketone strips. We compared readings between the two meters several times & they were identical. NovaMax is much cheaper out of pocket. I don’t recommend their glucose meter though.


I’ve seen other brands on Amazon since keto has become so popular, but we haven’t tried them.