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February 15, 2003

Gestational Diabetes

Question from Elma, Washington, USA:

I was recently diagnosed with gestational diabetes with my first child, and my doctor is telling me I have to check my ketone levels once a day in the morning, but I'm having a big problem with this. Because of urinary retention and nerve damage in my bladder, I have to use a Foley catheter to drain my bladder. Since all the urine just sits in the leg bag until its full, I don't know how I can get an accurate ketone reading. I can't take out the Foley because I would have to put a new one in and my insurance will only cover two per a month. Is there any way to check the urine for ketones if the urine has been in the leg bag for an hour or more? Will the level be the same after that period of time, or does it change if you eat or take insulin?

Answer:

For gestational diabetes, I do not recommend monitoring urine ketones. In your case, this seems very inconvenient as well as not very accurate. I would suggest speaking with your doctor about stopping this testing particularly if you only require a special diet to control your blood glucose. If oral hypoglycemic agents or insulin is necessary then checking blood sugars will be more helpful in guiding treatment.

OWJ