# Ketones



## mum2westiesGill (Jan 24, 2015)

mum2westiesGill said:


> FreeStyle Optium Neo - I've just ordered one online which is free
> 
> https://abbottdiabetescare.co.uk/our-products/freestyle-optium-neo
> 
> ...




So my meter arrived 2 days ago & my GP surgery have added ketone test strips to my repeat prescription list . I've been issued with 2x pks of 10 strips so hope this is enough.

I tried my meter out as you do & it said 0.1 ketones so I think that's ok.

How often should ketones be tested for?


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## Northerner (Jan 24, 2015)

mum2westiesGill said:


> So my meter arrived 2 days ago & my GP surgery have added ketone test strips to my repeat prescription list . I've been issued with 2x pks of 10 strips so hope this is enough.
> 
> I tried my meter out as you do & it said 0.1 ketones so I think that's ok.
> 
> How often should ketones be tested for?



You only need to test for ketones really when you are ill and have high blood sugar levels that you are finding hard to bring down. Outside of this there aren't any real reasons for ketone testing with the blood strips as it would be a waste, and with only 10 strips per box they disappear fast!  Better to use urine strips if you aren't actually poorly, but concerned.


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## mum2westiesGill (Jan 24, 2015)

Thank you Northerner


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## Sally71 (Jan 24, 2015)

0.1 is exactly what it should be (you very rarely get 0.0!) so well done.

You only need to test for them if your blood sugar is sky high (I.e.in the 20s), especially if it won't come down after corrections, or if you are being sick.  If you have a tummy bug and can't eat much it's a good idea to keep an eye on ketones as well as BG, although be aware that if you are not eating anything they you will have starvation ketones.

The rule is that 0.0 - 0.6 is normal
0.7 -  1.5 is ok as long as your BG is normal, if BG is high as well seek medical advice;
Over 1.5 seek medical advice immediately, especially if you feel ill or are being sick

The last time my daughter had a tummy bug I think her ketones peaked at 1.4 before she was able to start eating small amounts; then as soon as she was able to get some carbs back into her system the ketones disappeared very quickly.

We have had one or two occasions where her cannula came off overnight, which means she had had no insulin at all for several hours (you don't have long acting on a pump so if pump or cannula fails you are in trouble very quickly if you don't sort it) and she woke up to BG of 25 and ketones of 3.5 
But once we had got some insulin into her and new cannula in place the ketones went down very quickly, BG was a bit slower but all normal again in a few hours!

Keep an eye on the use by date of the ketone strips, they don't last as long as the glucose ones and you won't need to use them as much.  So make sure you order some more before they go out of date.


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## mum2westiesGill (Jan 24, 2015)

Thank you Sally


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## DeusXM (Jan 24, 2015)

Don't forget that in themselves, ketones aren't bad. Ketones don't just appear when you haven't eaten or not had enough insulin; they're a byproduct of metabolising dietary fat, which is a good thing.

Ketones with high blood sugar is a medical emergency, but ketones with normal blood sugar when you're confident your basal is high enough is fine - in fact, anyone looking to lose weight will actually want ketones as it proves you're burning fat.


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## Sally71 (Jan 24, 2015)

DeusXM said:


> Don't forget that in themselves, ketones aren't bad. Ketones don't just appear when you haven't eaten or not had enough insulin; they're a byproduct of metabolising dietary fat, which is a good thing.
> 
> Ketones with high blood sugar is a medical emergency, but ketones with normal blood sugar when you're confident your basal is high enough is fine - in fact, anyone looking to lose weight will actually want ketones as it proves you're burning fat.



Good point Deus!  My hubby has been doing a very low carb diet in order to lose weight.  He's done quite well and I think must have lost nearly 2 stone; but he STINKS of ketones!  I'd love to test him and see how high his ketones are, but don't want to waste a strip.  He's not diabetic so it's not a cause for concern.  If my daughter smelt like that and wasn't ill I'd be reaching for the cannulas 

(I've often thought that I hardly need a ketone meter, if daughter does have high ketones for any reason I can always smell them. Got a cold at the moment though...)


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## HOBIE (Jan 24, 2015)

Freestyle Libre test for Ketones as well. Its also a bg meter if you have the strips.


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## trophywench (Jan 24, 2015)

Well the pump version of the Expert always suggest you check for ketones if you are over something - 13 is it?  But if I knew the reason and it was eg, like just!  Oh bugger - didn't bolus for my dinner!  Ooops - I wouldn't test for ketones, cos providing I'm not ill they'll disappear anyway pdq.

Which is just as well, I've never had anything to test ketones with - did ask once when I'd just had the pump and we were going abroad on hols, and they would only give me pee strips.  Did try em out to see what they said, but it's no help really, I mean what do the individual levels mean anyway?  Obviously if they were the worst one or near that, more than a one off (I mean if they were what seemed amongst the high ones) combined with too high BG more than once after a couple of hours, I spose I'd have to go into illness mode, jabbing with a syringe - but I haven't ever been ill really so I certainly have had no practice.

That's when I'd be calling on YOU Sally and the other mums!  I had all the childhood things in childhood, I had septic tonsils the week before I got married in 1971 and the next time you could say I was ill, was 1972 and look where that landed me.  Since then I had a nervous breakdown in 2007/8 and I fully expect in hindsight the fact that eating my tea made me feel nauseous giddy and faint every night so I had to crash out on the settee every evening (except Saturday and Sunday - I wonder what COULD POSSIBLY have caused the stress? LOL) was ketones - but I was on MDI so fortunately I lived to fight another decade (hopefully!) - so I think I'd recognise it now, and also know what to do really.

Just that I've never had to.


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## HOBIE (Jan 24, 2015)

Another reason for "The Libre" ? £130 well spent


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## Sally71 (Jan 25, 2015)

No I wouldn't test for ketones every time BG went over 14 either, as long as it goes down again after a correction!  The only times I would check for them are a) if I can smell them (which usually means they are sky high due to some sort of cannula problem which needs attention pdq) or b) if she's ill and not eating much.  But then I'd probably only check once or twice, not every couple of hours like the DSN thinks I should.  And if she isn't eating then there will be some ketones there anyway; as long as BG is under control then you know enough insulin is going in, so ketones won't build up to danger levels anyway, will they?

I'm really not sure why ketones are such a big deal most of the time; whenever I speak to DSN when daughter is ill the first thing she asks is what are ketones like.  But the only time I can think of when you DO need to worry about them is when BG is sky high and won't go down again for whatever reason, and that doesn't happen very often!

Hobie I would love to try a Libre or some sort of CGM, daughter is adamant that she doesn't want anything else sticking in her at the moment though, and I don't want to push her on it unless our control starts to slip badly.  It's her body after all, and she has enough to put up with as it is.  Hoping I might be able to convince her when she's a bit older though!


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## jusme (Jan 25, 2015)

The Freestyle Libre isn't available at the moment Hobie, I tried to buy one a couple of days ago and they were out of stock, so I called them and asked when they would be in and was told February or March and they would let me know when they arrived back in stock. Also they are more than £130 now.

Jusme


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## Riri (Jan 25, 2015)

Hia Sally, I'm told, and I'm fact I've been there once, that ketones can develop when you're ill when BS show as normal so can still be a problem. I've read about so many unfortunate people who have developed ketoacidtosis and it sounds horrific and is so dangerous when it's got to that stage. Myself, I take no chances and test for ketones as per the guidelines and adjust by pump/pen accordingly. My DSN is always on at me to test for them if BSs over 13 and especially if I'm feeling under the weather. I have a meter and strips; I don't waste them but at the same time I use them as and when needed. Better safe than sorry!


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## HOBIE (Jan 25, 2015)

jusme said:


> The Freestyle Libre isn't available at the moment Hobie, I tried to buy one a couple of days ago and they were out of stock, so I called them and asked when they would be in and was told February or March and they would let me know when they arrived back in stock. Also they are more than £130 now.
> 
> Jusme



If you take the Vat off it is £130 Jusme !  They are good & that's why you may not be able to get one !   Good luck getting one    Cheap realy


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## Flutterby (Jan 26, 2015)

Just want to agree with Riri that ketones can be present at normal blood sugar levels when we are ill.  I had a chest infection a number of years ago and slept through without eating (or bolusing obviously) blood sugar was in normal range but I felt terribly sick.  I ended up being admitted with DKA and it has made me more vigilent about ketones ever since.  I don't test for ketones with every high but if I get a day of highs and especially if I feel remotely sick I do test.  It's a bit of a judgment call really but if in doubt test.


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## Sally71 (Jan 27, 2015)

Thank you Riri and Flutterby - I don't understand how you can get DKA with normal blood sugar, but clearly it is possible, so something for me to bear in mind next time daughter is ill!  I still don't think I'd test for them every time we hit 13, as long as it comes down again; but any prolonged high or illness I shall have to be a little more vigilant.  Thank you.

But my mum has been T1 since 1967 and has never tested for ketones in her life, and doesn't even own any ketone testing equipment 
She's never had DKA either!


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