ketostix

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void

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Relationship to Diabetes
Type 1.5 LADA
I hope this is the right place in gadgets but it's only a gadget in the sense that strips are a gadget :D
When would a t1/t1-LADA use a ketostick? I mean in what circumstance. How would it be interpreted?

If I'm physically active like sawing wood for example and the meter reads 10mmol would ketones (and what level) present indicate I've run out of insulin?

Same as above, but bg at 5mmol?

What's the threshold at which a dietary ketosis interpretation becomes a DKA one?

thanks
 
You wouldn’t test ketones if bg is 5, only if bg is 14-15+, two tests a while apart in a row or more
 
Basically, ketones become toxic when your BG levels are elevated, usually mid teens or above, because your blood then becomes more acidic. So if your levels are persistently 14+ and not just a meal spike, but elevated for several hours and not coming down or responding to corrections, then you would test for ketones. This would be particularly likely if you were ill or perhaps if you were using a pump and it malfunctioned or if you had forgotten to inject your basal insulin.
It is not something I have ever had to do in the past 4 years and I can't really envisage it happening because if my levels rise I inject insulin and if they don't come down I inject some more and I am not afraid to stack insulin corrections hour after hour if I need to, in order to get it back down. Maybe that sounds a bit cavalier but Libre gives us the ability to monitor our levels closely and if I am stacking corrections I always have plenty of JBs to hand and my reader to keep a close eye on my levels and I record every correction so I have a good idea of when they will expire and roughly how much is left. If an hour after a correction, they are still going up, I jab another one. I would rather start correcting at 8 with a couple of units if it is drifting upwards (not a meal spike) as let it get to 13 or 16 and be needing larger corrections.
 
thank you both thats v helpful
 
rebrascora said:
Basically, ketones become toxic when your BG levels are elevated, usually mid teens or above, because your blood then becomes more acidic. So if your levels are persistently 14+ and not just a meal spike, but elevated for several hours and not coming down or responding to corrections, then you would test for ketones. This would be particularly likely if you were ill or perhaps if you were using a pump and it malfunctioned or if you had forgotten to inject your basal insulin.
It is not something I have ever had to do in the past 4 years and I can't really envisage it happening because if my levels rise I inject insulin and if they don't come down I inject some more and I am not afraid to stack insulin corrections hour after hour if I need to, in order to get it back down. Maybe that sounds a bit cavalier but Libre gives us the ability to monitor our levels closely and if I am stacking corrections I always have plenty of JBs to hand and my reader to keep a close eye on my levels and I record every correction so I have a good idea of when they will expire and roughly how much is left. If an hour after a correction, they are still going up, I jab another one. I would rather start correcting at 8 with a couple of units if it is drifting upwards (not a meal spike) as let it get to 13 or 16 and be needing larger corrections.
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I think the main risk of getting ketones for you then would be if you were ill, or if something had happened to your insulin and it had gone off.

Remember that the urine ketostix are only good for 3 months after the pot is opened so if you you have to open a pot to check for them you might as well use the rest of the pot over next 3 months if have highs
 
Hi @void I only test if I am above 14 for an extended periods of time. I sometimes have a spike after a meal if I miscalculate my carbs or don’t manage to /remember to pre-bolus, but for those I would just wait it out.

My current strips are valid for 6 months from opening. Check on yours and then perhaps write the discard date on the pot, and check that you replace them. The pots have different scales written on them and also colour codes for each level. Use the scale on your pot and ask DSN/GP/Nurse if in doubt. Worth doing this before you need to. Once you are ill and battling with ketones, (which is when they are most likely to occur) you don’t want to have to start finding out info, you just want to focus on corrections and drinking lots of water.
 
thanks
 
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