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Would you check your blood or urine for ketones in any of the following situations? Please select all that apply.
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None. Because I don’t have strips. But, if I had a high I couldn’t get down or had a high with nausea I would go to ER if needed and have them check. But in 35 years I’ve never been in DKA, exception might have been at dx but no clue due to being age 4.
I am with you and do not keep strips around. But in 66 years I have never been in DKA either.
I agree. The only time I had high keytones is when I was first Dx.
My BS has never been as high as 250. I would have corrected well before it got that high.
What is ketones
Assuming that’s not snark, it’s what your body starts to generate when it starts burning cellular fat deposits rather than glucose for energy. Sometimes people do this on purpose by severely restricting carb intake (ketogenic diets, e.g. Atkins) in order to lose weight. But it’s also why sudden unexplained weight loss is one of the classic symptoms of T1. And ketones are also toxic if you have too high and sustained a level of them in your blood, because it changes the ph of your entire circulatory system, essentially hammering every cell in your body, leading to unconsciousness and ultimately death. Also known as Diabetic Ketoacidosis (DKA) or “diabetic coma,” which is an ambiguous term and probably shouldn’t be used because non-D people sometimes seem to confuse it with the effects of hypoglycemia, which is actually the opposite of DKA.
William, good answer! I tested trying to maintain “moderate ketosis” with the ATKINS diet 25 years ago but otherwise never tested in any scenerio. Every diabetic who is active and alive risks highs and lows, A “250” and a “50” will come up but with a CGM neither are what they were 25 years ago. But from what I’ve read children are predominantly concerned with DKA after diagnosis, even if many were diagnosed diabetic in DKA.
I guess I would if I had strips. I used to buy them but found they all expired and I never needed them.
If I get over 250 for any amount of time I check to make sure there isn’t something blocking insulin delivery or absorption and probably just change out my whole reservoir and set just in case. B/c I never get that high under normal circumstances. Or at all, really.
I just bought a blood ketone test meter to have on hand. Even though I rarely have out of control BGs, I’m about to have major surgery and things might get pretty wild. I like the idea of having access to ketone data for problem solving (and I’ve always had a weakness for gadgets.)
This question is a bit ambiguous. Stubborn BG over 250 could be “sticky “ from high fat/protein meal with possible carb count incorrect. Also, trend arrow and rate of change, as well as whether illness is present.
I was taught early on to employ “sick day” rules: BS greater than 240 over a four hour period absent food considerations, check for ketones; if ketones present take a bonus of regular insulin equal to 20 percent of daily doses. Repeat until ketones are negative. Served me well during flus, stomach virus and hangovers. Pumps have changed things but I still follow this guidance with some tweaks.
I have never checked for ketones in over 30 years of diabetes. A doctor has never instructed me to. I have LADA. If my blood sugar goes high above 180, I work very hard to get it down below 180 very quickly with insulin and sometimes exercise. I bring it down fast and catch it at the bottom with juice or something else if I have overdone the insulin. With the faster acting insulin it works better not only because it brings my BS down faster but because the insulin is used up faster. I have wanted to try inhalable insulin but my Endo is not ready for that yet.
I simply don’t spend any significant amount of time above 125. Again, why is the question asked from the point of view that hyperglycemia is unavoidable for diabetics? Any time spent above 125 is damaging to long term health.
Even non-diabetic people go above 125. Also, there are people who get sick and their sugar jumps even if they are normally under 125. Infusion sites also get knocked out without a person knowing. Just because a person is normally under good control doesn’t mean their sugars can’t go high for some reason.
I would add “during sickness”, especially when high and sick.
I haven’t tested for ketones in many years. I use my internal nausea meter. Have been able to catch it in time that way.
I very seldom go over 220, but I ever did for more than 6 hours I would probably check for ketones, using outdated ketone strips.
I don’t keep strips on hand as I’ve never personally experienced ketones in the absence of high blood sugars, and I’m vigilant about high blood sugars. My protocol for site-failure highs is aggressive and treats for both high BG and ketones: at the first sign of site failure change the site, inject an insulin bolus into a muscle, drink lots of water, watch the BG descent, eat carbs when dropping. With the few overnight site failures I’ve failed to catch early, I find that ketones cause obvious nausea and discomfort when building up and respond quickly to the above treatment.
I do not check for keytones unless I have been running high for a couple of days, or I am sick.