[jillsp]

How often (if at all) does everyone check for ketones. I can honestly say in 15 years I have only checked once and I already knew I was in DKA, my husband made me do it before dragging me to the ER.

[JediSkipdogg]

Ummmmmmmm....last time I checked was maybe 10 years ago. I personally don't see the point in it, even in mild DKA, where a doctor says you need immediate medical assistance, you can bring yourself out of it. And if you are severe enough that you can't walk or drive or something, then you need an ambulance anyways and let the hospital figure out you are in DKA.

[Cyborg]

I check when my bg gets real high (400)...

[jillsp]

Originally Posted by Cyborg

I check when my bg gets real high (400)...

Can I ask why? I guess I don't really understand why I would do that b/c I don't think it would change my course of action. Is it just that you want to know to be safe or sure? I've seen lots of people posting on here about checking ketones and I have never thought to do it. Just wondering if I'm missing the boat somewhere......which is very possible!

[JediSkipdogg]

I'm seconding jill's question...And this can be answered by anyone...

If you have ketones what do you do differently than if you don't have them and are running say 400? Isn't the goal to bring the BG down either way? What can you really do different if ketones are present verse if not?

[Cyborg]

For me, it's assurance as to whether I'm heading for ketoacidosis or not. My bg does not normally go that high any longer. If it is that high, than something is wrong. Treatments are both the same to get the bg down, but if showing large ketones, I may use a syringe rather than my pump, etc...

[camjen1]

I also hardly ever check for ketones. The last time I checked I was also in DKA. I don't think having a little amount of ketones warrents a ER visit. It just means you have to do a bit more aggressive treatment. There were a handful of times where I sensed I was going into DKA but treated it asap and I was fine a few hours later.

[poodlebone]

I usually check just for the **** of it when my meter tells me to. I think that's any BG over 250. Most times it's negative or a trace. The only times it read high was when I had a bad set in. But seeing the strip go to the "large" color (next to last color) didn't make me do anything differently. I just put in another set, took my correction, and drank water.

I think that in my Minimed pump manual, it says something about a situation where you can have ketones but not have a really high BG. It said you're supposed to drink something with sugar in it and take insulin to cover the carbs. I'm not sure why. I know in the past I've shown moderate ketones with a BG of only 180 or so, but that hasn't happened since I started pumping.

I don't think I'd ever go to the ER just for a high BG + ketones, unless I was vomiting and feeling really sick. Otherwise I treat myself like any other high reading.

[sofaraway]

my doctor likes me to check for ketones if my blood sugar is above 20mmol/l. i can test on my meter so it's not a big issue. if i was to have ketones above 0.6 then i have to seek medical attention. but it's highly unlikely that would ever happen being a MODY. when i was admitted a few months ago with a blood sugar of 32mmol/l ketone reading was 0.0.

[poodlebone]

I also want to say that the reason I usually check over 250, even though I doubt there are ketones, is because I paid for the stupid strips and figure I might as well use them up before the 6 month expiration. I have used a vial longer then 6 months after opening but eventually threw it away and got a new one.

I wish they came in smaller vials. 10 strips in a 6 month period would be more than enough.

[JasonSmithMT]

You check ketones because ketoacidosis is very serious and life-threatening. Things can go very bad very quickly. Even though initial home treatment for a high blood sugar with moderate ketones is not very different from treatment for high blood sugar without ketones present it is worthwhile to monitor because of the seriousness of DKA. It not terribly difficult to slip into DKA with moderate to high ketones present even while blood glucose levels are dropping. Once DKA sets in, home therapy is not going to be enough (or too risky). You need a lot more than just insulin with DKA. It is fairly simple to monitor ketones at home with either urine or preferably if available blood every few hours so why not do it? Are they really that expensive? Is it that much of hassle to test? If ketones continue to go up or if any nausea occurs it might just save your life.

Jason

[camjen1]

I just wanted to clarify myself a bit. When I said that little amounts of ketones doesn't warrant a ER visit what I really meant to say is if you have traces of ketones but are feeling fine then I wouldn't make a trip to the ER. Now on the other hand if you have traces of ketones and doesn’t feel like yourself and you feel you have to vomit then I would say pack your bags and prepare for a stay at the hospital. Please don't rely on my advice only though because what may work for me doesn't work for everyone.

I don't mess around anymore. The day I went into DKA happened so fast and by time I got to the hospital my Blood pH was 7.04. I was vomiting every 30 seconds and had nothing left in me. At that time I didn't care if I died because I was miserable.

[jillsp]

Originally Posted by JasonSmithMT

You check ketones because ketoacidosis is very serious and life-threatening. Things can go very bad very quickly. Even though initial home treatment for a high blood sugar with moderate ketones is not very different from treatment for high blood sugar without ketones present it is worthwhile to monitor because of the seriousness of DKA. It not terribly difficult to slip into DKA with moderate to high ketones present even while blood glucose levels are dropping. Once DKA sets in, home therapy is not going to be enough (or too risky). You need a lot more than just insulin with DKA. It is fairly simple to monitor ketones at home with either urine or preferably if available blood every few hours so why not do it? Are they really that expensive? Is it that much of hassle to test? If ketones continue to go up or if any nausea occurs it might just save your life.

Jason

I asked the question b/c the one time I have been in DKA, I already knew it without checking for ketones (even though I checked to appease my husband). You don't have to be a rocket scientist to figure it out when your blood sugar is 400, you are vomiting uncontrollably and can't see straight. It wasn't a flippant question, it just seemed lots of people on here talk about checking their ketones and I don't do that....even if my blood sugar is 400. I'll get a 400 and feel fine, so I pump up a bolus, monitor and move on. I just wondered what everyone else did. It seemed like you just jumped down our throat. I realize DKA is VERY serious....it's kinda hard not to know that when you have Type 1.

[lgvincent]

I can't recall the last time I did it. I used to do it whenever my blood or urine sugar was high but it was so rare that I spilled ketones that I stopped. I've been trying to find a way to lose some weight and I understand that burning body fat creates them so in I'll probably need to start checking them to see if my efforts are working.

[notme]

I haven't checked for ketones in at least 18 years. For me, the course of action would be the same as always if I am high and producing ketones. I assume if I am over 250 that there is a problem and would treat exactly the same.