Ketone testing methods

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Tdm

Tdm

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Just checked my ketone finger pricks strips and they have just expired. The previous strips expired 2 months ago.
I don't really use them but like to have them in in case I am sick, in which case i won't have time to order them in and msy not feel like walking to the chemists. I have heard ketosticks mentioned, do they have a longer shelf life? Or was i just unlucky in having the strips expire so quickly?
 
I have Ketostix (urine dip tests). If I remember correctly, they last 6 months after opening.
 
I had some FSL ones that used the reader but like you they were out of date when i had covid when my sugar rocketed.
 
I am fortunate in that I don't seem to be too prone to ketones.

As such I'm happy to rely on the less accurate and less immediate ketostix. They last a few years unopened, and 6 months once you've used the first one.

I'm probably due to replenish my previous unopened pot with a fresh one at the end of the summer.

I think they cost the NHS about a fiver for a pot of 50, rather than £2.50 per strip - so I'm happy to have the relative inaccuracy since I use them so rarely.
 
I'm much like you @everydayupsanddowns - and though I'd never before had any means prescribed of checking ketones - it really put the wind up me when I broke my knee and not only having ragingly BG but ditto ketones, so then got some prescribed. I used about half a dozen but then stopped panicking and only used a couple since. Now of course they're out of date - and undecided whether to order some more or just not bother again.

Of course I know that having very high blood ketones is life threatening PDQ if insulin is not also added PDQ - BUT how long do I need to have my BG under 13.0 to absolutely avoid killing a brain cell? Cos like it or not I'm now 'elderly'. Daft (or are they?) imponderable questions, like if I had to for whatever reason, go into a Care Home (or even a Nursing Home with 'proper' nurses) how expert might the staff of any of them anywhere be, at looking after anyone with insulin controlled D ?

More than A Lot of HCPs have no idea where to best prick a finger 'to test your BMs' so when you say 'Not there!' emphatically and try to pull your hand away - think it's YOU 'just being a too fussy old woman' (when I'm just doing my normal job, so Pah!) - as I'm pretty well experienced at reading faces and can easily see what they're really thinking 😱 (I always enjoyed training people)
 
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I am fortunate to live in Germany and both Ketostix and FreeStyle Libre ketone test strips are covered by insurance so I keep both on hand.

When I'm ill, I use the Ketostix each time I use the loo (when I'm feeling well enough to test) and use the ketone blood test strips once or twice a day, depending on the results I get and what stage I'm at in the course of my illness.

I got my current ketone supplies replenished in April 2023. The Ketostixs have an expiration date of July 2025 (as others have said they are only good for 6 months after opening) and the FreeStyle Libre ketone test strips expire in July 2024.

I had a few FreeStyle Libre ketone test strips that had expired and out of curiosity tested to see if they still worked in the meter past the expiration date. I wasn't sure if the meter would recognise that the strip was expired and throw up an error, but it worked fine. I'm not sure if they were accurate, but they did still work.

And for anyone curious, the same FreeStyle Libre ketone test strips that work in the FreeStyle Libre 2 readers also work in the FreeStyle Libre 3 readers, even if they don't say it on the box.
 
trophywench said:
Of course I know that having very high blood ketones is life threatening PDQ if insulin is not also added PDQ - BUT how long do I need to have my BG under 13.0 to absolutely avoid killing a brain cell? Cos like it or not I'm now 'elderly'. Daft (or are they?) imponderable questions, like if I had to for whatever reason, go into a Care Home (or even a Nursing Home with 'proper' nurses) how expert might the staff of any of them anywhere be, at looking after anyone with insulin controlled D ?
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Interesting you should say this, as I have similar thoughts - being slightly younger mine were more to do with if you were seriously unwell in hospital, would all HCPs necessarily know what to do? My father is a retired nurse and care home manager, and thankfully he tells me there was proper training required when caring for someone with T1D, especially if you were seriously unwell and unable to communicate for any reason, but it does make you wonder! We need to come with an instruction manual :rofl:
 
I have the urine test strips, which last for ages before opened. Once opened I write the discard date 6 months ahead on the container.

When I was very poorly I was given some FSL ketone test strips as I wanted a more immediate/accurate result. Now that I rarely use a Libre I have reverted to Ketostix only.
 
I only have the urine strips though I’d like to know more about the differences in urine and blood ketones. I’m very prone to urinary ketones and get them after even just having a meal with not many carbs in. Skipping an insulin dose or being unwell gives me very high urine ketones.

But whenever I’ve been sent to hospital because of mine and GP urine strips showing highest level of ketones, my blood doesn’t have a worrying level of ketones.

It’s not that the strips are inaccurate as mine and GPS would both say very high ketones on multiple occasions.

So there must be something different being measured between urine and blood ketones?
 
Lucyr said:
So there must be something different being measured between urine and blood ketones?
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Ketones form in the blood, so a blood test is where they'll be spotted first. As your body clears the ketones, they come out in your urine, so they'd show up in a urine test later. A blood test and urine test taken back-to-back probably won't give the same result.

Besides the plus of detecting ketones sooner, blood ketone tests (at least the FreeStyle Libre ones) give a number rather than a colour shade like the urine test. Blood tests are also more convenient than urine tests, but they do require a lot of blood. But if you're self-funding ketone tests, it sounds like Ketostixs are a lot cheaper.
 
Finn said:
Ketones form in the blood, so a blood test is where they'll be spotted first. As your body clears the ketones, they come out in your urine, so they'd show up in a urine test later. A blood test and urine test taken back-to-back probably won't give the same result.

Besides the plus of detecting ketones sooner, blood ketone tests (at least the FreeStyle Libre ones) give a number rather than a colour shade like the urine test. Blood tests are also more convenient than urine tests, but they do require a lot of blood. But if you're self-funding ketone tests, it sounds like Ketostixs are a lot cheaper.
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One of the times I had the ketone test it was a urine test at home (max ketones), a urine test at the out of hours GP (max ketones), admitted to hospital for bg of HI and urine ketones of max, then blood from my arm had 0.x (x being small) ketones even though BG was still HI

That’s why I feel like I get false positives in urine and that it’s more than just a time difference? If I’d cleared the ketones surely my bg wouldn’t have still been HI? I don’t understand the differences enough to know if something else could trigger urine but not blood ketones though.
 
It's just the difference between the body completely clearing every trace of the ketones that it has processed out of your bloodstream into urine and your clinically completely clearing that out of your bladder whilst the body constantly drips pee into the bladder anyway so that does take ages, the fresh urine dripping in only dilutes what's left in the bladder until it's full enough to signal that you need to wee - and the bodily blood circulation system, which is obviously quite a lot speedier.

I dunno what the precise time differences are either between circulation and plumbing, nor how well anyone can be assumed to 100% empty their bladder.
 
I guess it is similar to the difference between our blood glucose meter measurements and the dark old days of testing urine for glucose levels.
 
I was told I only need to test for ketones if BG is consistently above 15, so I haven't needed to test for ages. But just checked the strips that were prescribed for my Dual meter in May 2022 & they expired in March. So it seems they only have a relatively short shelf life. But having said that, they are individually foil wrapped & I'd be comfortable using them for an indicative reading.

From my experience of post-Covid DKA last year, there would have been plenty of time to order ketone strips if I'd have had a meter to see my levels had risen in the first place!

But presumably your meter is provided on prescription, so the strips should be too? So maybe just check the expiry date next time you collect from the pharmacy & request a fresher batch if it's short.
 
Like @Tdm, I am concerned about wasting ketone testing strips and NHS money.
Even if they were included on an insurance elsewhere, I would not want to increase the insurance amounts but getting unnecessary medications and medical equipment.

And, like @everydayupsanddowns , I do not seem to be susceptible to ketones.

However, I have the Abbott ketone strips which fit my meter. It is something I have thought about as they expire but, as I travel a lot, I prefer to have the convenience of something that is easy to carry. I rarely get through a whole pack before they expire but I will occasionally test when my levels get into double figures.

Until I started pumping, I had never heard of ketone strips let alone have any. I was not prescribed ketostix or any method of testing. Given the risk of undetected pump failure leading to higher BG pretty quickly (because I have no basal insulin), I consider them a form of insurance. Maybe if I was on MDI, I would be more relaxed.
 
Matchless said:
I had some FSL ones that used the reader but like you they were out of date when i had covid when my sugar rocketed.
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I only had the FSL ketone tests because my endo said i should have some but i think i have only tested for ketones twice in 30 odd years when i have the flue or covid .
 
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