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Re: [IPk] Re: ketone testing

"Within hospitals, it is, of course, possible to do a huge range of 
bllod tests extremely quickly. And in ketoacidosis there are a variety 
of figures that are more important than the absolute level of ketones."

There have been some recent studies published where the length of time of 
patients in hospital with DKA have been compared to the length of time spent 
in hospital if the blood ketone level had been monitored. It was found that 
the stay in hospital could be reduced by about half the time by monitoring 
blood ketones.

"I remain slightly sceptical about the value of home blood testing for 
ketones. Other than the fact that like blood glucose testing, it 
provides a "here and now" value, the actual level is so often less 
important than the fact that ketones are there at all. Or certainly the 
crude difference in levels on the urine tests is enough to know whether
you are a) have loads of ketones or b) you are getting worse instead of 
better and in both these cases thats when you definitely need some help."

The urine ketone sticks measure a different ketone than what is measured by 
the blood ketone meter. The urine test measures acetoacetate and the blood 
test measures beta-hydroxybutyrate. The primary ketone body is 
beta-hydroxybutyrate which is therefore a truer measure of a person's ketotic 
state. In DKA, the blood ketone test will see a drop much quicker than would 
be seen using the urine ketone test.

The other point is that we always have some ketones, but the normal level is 
too low to be detected by the urine sticks unlike the blood test. Therefore, 
a person could detect a rise in ketone levels sooner using the blood test 
than could be detected by the urine test. Another advantage for using the 
blood ketone test is that you would get a digital reading rather than having 
to match the colour change of the stick to the chart. The digital reading 
would certainly be a more efficient way of checking to see whether or not you 
are improving in a DKA situation.

I hope that this makes sense.

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