I have heard some parents say that they don’t check for urinary ketones and that checking them that way is the stone age way to check them. They say the best way now is to check them through blood. I was always told you always check for ketones if the blood sugar was over 250 mg/dl [13.9 mmol/L] and during an illness. Some of these parents that I have met have only checked their kids once, saying that there is nothing they can do except push more insulin when there are ketones. Have you ever heard of this?

While blood ketones are an accurate test, it requires an Abbott meter, the Precision Xtra, which some insurance companies will not cover.Urine ketone strips can be obtained in foil so they don’t “go bad”, where the ones in the bottle are usually no good by the time you need them again for the next illness.

Ketone testing is useful when ill or when blood sugar is very high. It helps you know “how ill” you are. The parents are correct that you need to give insulin for ketones, but you must also give fuel, usually as glucose. For carbohydrate counters, I have them give carbohydrates such as Gatorade, regular soda, etc., count the carbohydrates and give the appropriate dose of insulin every three hours until all is better. It takes extra insulin and fuel to correct the ketones. This is different from just a high that needs insulin to bring it down. So, I think ketone testing is important and should be done however, urine or blood. If possible, blood is better.

LD

[Editor’s comment: Also see our web page on Hyperglycemia and Ketone Testing.

BH]