Recently blood glucose meters were developed that allow you to test for ketones in your blood as well. You can test your blood with the strips for glucose and then switch the strip and test for ketones using the same fingerstick. What really is helpful is that the strips are individually wrapped and good for two years so you do not waste them and end up being much cheaper than throwing away a jar of unused urine strips. This is an important new development and it is hoped that it will reduce the incidence of DKA.
Urine ketone testing is still available and is an alternative for someone who chooses not to test their blood for ketones. Ketostix strips are available and it is a simple dip stick that you put into urine and then compare the color
of the strip to the color chart on the bottle. Be careful to not bend the strip, keep the lid on the strips tightly and review it in good light. Urine strips can go bad quickly and give you incorrect readings when they go bad. They should not be kept in a bathroom medicine cabinet where moisture can effectaffect them.
Why and where should you test for ketones?
You may then ask why test at all. Ketone testing shows that you are in balance and that your body is working well under stress. We diabetes educators talk about Sick Days all the time and the reality is that everyone gets sick
sometimes. I am not talking about "diabetes sick" but the things that occur with everyone. Colds and flu or upset stomachs can mess up your system enough to start ketone development. If you cannot eat or keep food down you have no glucose to use for energy so your body starts to burn fat. While it is true that you can have elevated blood glucose and not develop ketones, each person is different. Some people will develop ketones with blood glucose of 250 or less and for others it will take blood glucose of 500. That is why glucose and ketone testing go hand and hand.
The American Diabetes Association recommends that you test for ketones:
If your blood glucose is above 250mg/dl; If you have an injury, infection, illness, fever, cold, nausea, vomiting, or diarrhea, or abdominal pain, or you have symptoms of DKA. If DKA is not treated it can lead to dehydration, confusion, coma and even death.
I have seen patients in each of these conditions and it can be very frightening for the patients and their families. One patient became so confused and frightened that he picked up a television and threw it at the staff. He had
to be restrained and sedated. After the episode he had no memory of what had occurred. You and your health care provider should decide when it is right for you to test in order to meet your needs and give you the information both of you need to keep you well.