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[IPk] Re: ketone testing

> Date: Mon, 25 Sep 2000 10:35:48 +0100
> From: Diana Maynard <email @ redacted>
> Subject: [IPk] ketone testing
> I got into an interesting discussion about ketone testing at the
> weekend
> with someone who has type I diabetes, is on a pump, and is also a
> medical
> professional (in the US), and who thought ketone testing was a waste
> of
> time.
> Personally I never test for ketones (mainly because I can't read the
> visual
> strips), but I've always thought it seems like a sensible thing to
> do. 
> Medisense have now brought out a new meter that tests for both BG and
> blood ketones, which seems like a great idea, but maybe it's just a
> marketing ploy. After all, if your BG is high, and doesn't come down,
> you
> know you're in trouble anyway, and anyone with a reasonable amount of
> intelligence would be aware of when the time to start getting worried
> would be.
> Personally, I'd like to know just for curiosity's sake (a bit like
> testing
> when you know you're hypo, just out of curiosity to see the exact
> figure),
> but I wonder if anyone has any compelling reasons why it's really
> necessary. I've never tested for ketones in 21 years of diabetes, and
> have
> never had DKA, though I've had plenty of high BGs.

I found the comments on ketone testing after a night where you suspect
you might have had a hypo without being aware, very interesting -
hadn't thought about that, and it happens to me quite often, so I'll
try next time.

The one time ketone testing was really useful for me was last winter
when I had flu.  For several days, I drank lots of water and
unsweetened herb tea and clear soups but hardly ate or drank any carbs,
raised the basal rate on the pump, tested frequently and had very
nicely low blood sugars, and couldn't understand why I was feeling
increasingly lousy.  Suddenly in the middle of the night it occurred to
me that the only previous time I had ever felt quite like this was just
before diagnosis of DM, and for sure this was DKA. Ketostix confirmed
it, but only showed relatively small amounts of ketones, so I waited
till morning, by which time things were worse.  This was the first time
it had happened to me since diagnosis, and in my inexperience, I didn't
know what to do, but got myself somehow to the GP first thing in the
morning.  Wished I had known already in the night that the first thing
to try in case of ketones with relatively low blood sugar was sweet
drinks and lots of insulin - could have avoided a few bad hours, and
making a spectacle of myself in the GP's waiting room.  The other moral
of the story is to test ketones liberally when ill - they can go high
even if you dont have the more obvious warning of high blood sugar.

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