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Testing for keytones

MarkStAlbans said:
General question,

What are the views on keytone testing?
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If you need to test them then test them. If you don’t then don’t.

Do you need to test them?
 
I'm impressed you got a prescription for strips which I understand are expensive. I went on dapaglifozin last September and was given ketostix. I've since discovered you can buy them cheaply without prescription. I have mixed feelings about dapaglifozin because I was eating between 100 and 120 carbs per day but wasn't able to find out how much I needed to up and because the more carbs I eat the more I want!
I lost a stone between diagnosis and going on medication and 2 further stone since. My bmi is now a healthy weight.
I have high blood pressure which is why it was chosen for its cardiovascular protection.
 
saffron15 said:
I'm impressed you got a prescription for strips which I understand are expensive.
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Urine strips are very cheap it’s only blood strips that are expensive
 
saffron15 said:
I'm impressed you got a prescription for strips which I understand are expensive. I went on dapaglifozin last September and was given ketostix. I've since discovered you can buy them cheaply without prescription. I have mixed feelings about dapaglifozin because I was eating between 100 and 120 carbs per day but wasn't able to find out how much I needed to up and because the more carbs I eat the more I want!
I lost a stone between diagnosis and going on medication and 2 further stone since. My bmi is now a healthy weight.
I have high blood pressure which is why it was chosen for its cardiovascular protection.
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I have high blood pressure which is fully controlled by lorsartan.

I got them added to my prescription by just asking my gp practice, no drama
 
MarkStAlbans said:
Ah 🙂
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Like I said earlier though, if you’re eating very low carb then any type of ketone stick “to use when ill” is a waste of money. You won’t know that normally you have ketones because or your low carb diet, you’ll test when ill and see you have ketones, and then what is your plan?
 
My plan is simple, if the keytones are significantly raised ie above 1 which I did not have even when I was diagnosed then its a paramedic call.

I will only check when Ill
 
MarkStAlbans said:
My plan is simple, if the keytones are significantly raised ie above 1 which I did not have even when I was diagnosed then its a paramedic call.

I will only check when Ill
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Why 1? A ketone value of 1 doesn’t require a call to 999 for a type 1 so can’t see why it would for a t2 on a low carb diet
 
1 To 1.5 is increased risk of DKA. I asked my endochrinologist about this and that was his view. Im just following his advice, feel free to differ.
 
MarkStAlbans said:
1 To 1.5 is increased risk of DKA. I asked my endochrinologist about this and that was his view. Im just following his advice, feel free to differ.
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Why an ambulance though for ketone value of 1. Why not the regular advice for T1s of drink plenty or the logical t2 on low carb diet advice of have some carbs, or the sensible see if you have any signs of DKA, or call 111 / GP or drive or get a lift to a&e?

A ketone value of 1, with risk factors for likelihood of getting ketones (low carb), and no DKA risk factors (it’s very very rare in t2 and you’re not on any medication that could make DKA likely), simply means an ambulance for a ketone value of 1 is an overreaction. Ambulances are for emergencies so would only really be appropriate if you have symptoms that warrants one.
 
My daughter had ketones of 1.5 when she had a tummy bug and couldn’t hold any food down. We didn’t need an ambulance. In that instance they are a normal byproduct of your body burning up fat in the absence of carbohydrate. We were in regular contact with diabetes nurses and they said just make sure she keeps sipping water and get back to them if the ketones go any higher. They didn’t, as soon as she was able to start eating small amounts they went straight back down again. We’ve had ketones higher than that before because of pump or cannula problems and didn’t call an ambulance, just dealt with the problem and that sorted it. I know you’re being careful and trying to do what you’ve been told, but calling an ambulance for a ketone value of 1, especially if you have no other symptoms, seems a bit of an overreaction and could potentially take an ambulance away from someone who is in a life-threatening condition. If you’re worried you could make your own way to a doctor/A&E to get checked out.

My mum has been type 1 since 1967 and has never done a ketone test in her life, and is still here at the grand old age of 81
 
Sally71 said:
I’ve always found it a bit of a waste of time to be honest, never tells us anything that we don’t know already, and any ketones which are present go away again as soon as the problem is resolved.
For a type 1, you only need to test for them if a) you have had very high blood sugars for several hours that are not coming down after insulin corrections, or b) if you are ill. Even then, if you are not eating much (e.g. if you have some sort of tummy bug) then you know you will have some ketones present because of not eating. For a type 2 I don’t know what situation would require it to be honest, maybe some type 2s will be along soon!
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I have exactly the same view. I didn't bother testing (had no method of doing so) for ~25 years and it never caused problems. I always have IoB, if I'm high I take insulin to correct it, there's little else to it as I'm MDI

I only got a meter as I was curious about what happened during exercise, and also about the fact that people seemed to be so fearful all of a sudden so was interested to see what my numbers looked like.

I've posted some values I've had after reasonably long endurance exercise, along with some other thoughts in the thread here: https://forum.diabetes.org.uk/boards/threads/normal-ketone-values.110801
 
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