# confusion with ketones



## litto-miss-loz (Jan 8, 2011)

hey guys,

im a tad confused here lol

i have a sick day insulin pump guidline sheet to follow when i have ketones and it has two sections.

one is for if you have neg-trace urine ketones or 0-1.5 mml blood ketones and the other is if + or more urine ketones or 1.5-3 mml blood ketones.

Now yesterday when i found out i had ketones I checked with my blood meter and with the urine sticks and the blood meter said 0.8 but the urine stick had plus ++++ ketones.

now on the sheet it says if its more than plus + or 1.5-3 then follow the guidlines but i was ++++ and 0.8 on meter. But 0.8 according to the guidlines would be if i had neg-trace ketones but then the urine sticks indiciate I need to follow the 10 or 20% guidline. so what one do i follow??

do i go straight for the urine ones or use the blood ones??? 

ta mucho


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## Northerner (Jan 8, 2011)

As I understand it, the blood ketone strips show your current situation, whereas the urine sticks will show the situation from some time earlier. What appears to have happened is that you have succeeded in helping to process the ketones out of your blood into your urine by giving the corrections you did. When your body is lacking insulin it can't process the ketones out of your blood and this is why they can build up to high levels, plus your body will continue to produce more ketones as it burns fat because it can't process the glucose in your blood. 

So, what that means is, without sufficient insulin, you will have high glucose and high ketones that will keep building up. Once you provide insulin then the ketones can be processed out and your body will be able to use glucose again. So I think the difference in the blood and urine test shows the before and after of the corrections you made. What are your BG levels like?

It would be a good idea to contact your DSN to discuss this though - I'm not a doctor!


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## margie (Jan 8, 2011)

Northerner is correct that the blood ketones tell you what is happening now, whilst the urine ones tell you what was happening a couple of hours previously.  This was covered when I did a carb counting course.

Of course if you haven't been eating properly you can also get fasting ketones which can confuse the situation. Personally I think we should be given urine strips that test for the ph of the urine - as this is a good indication as to whether your blood is turning acidic.


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## shiv (Jan 8, 2011)

As Northe and margie have said, blood ketone tests give up-to-date info, urine ones give very out of date info! Trust the blood one.


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## litto-miss-loz (Jan 8, 2011)

Northerner said:


> As I understand it, the blood ketone strips show your current situation, whereas the urine sticks will show the situation from some time earlier. What appears to have happened is that you have succeeded in helping to process the ketones out of your blood into your urine by giving the corrections you did. When your body is lacking insulin it can't process the ketones out of your blood and this is why they can build up to high levels, plus your body will continue to produce more ketones as it burns fat because it can't process the glucose in your blood.
> 
> So, what that means is, without sufficient insulin, you will have high glucose and high ketones that will keep building up. Once you provide insulin then the ketones can be processed out and your body will be able to use glucose again. So I think the difference in the blood and urine test shows the before and after of the corrections you made. What are your BG levels like?
> 
> It would be a good idea to contact your DSN to discuss this though - I'm not a doctor!



im still confused lol cause what i done was the 20% rule for the ++++ urine ketones and that seemed to have worked but if i had followed the 0.8 blood ketones that might not have been enough insulin to cover it ?? 
its confusing also cause when i have been in hosp with ketones they follow the urine ones. this blood ketone thing is relatively new to me and i just panicked yesterday when i seen ++++ cause i thought i was going to end up in hosp.

my bg levels today or when i had ketones??


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