ketone meters ?

Esme12, ASN, BSN, RN · Jan 5, 2012

the only information i can find is for peds patients. i hope this helps

there are two ways to test for ketones: urine testing and blood testing. just as blood glucose testing proved to be superior to urine glucose testing, so too is blood ketone testing proving to be better than urine ketone testing. ketones appear first in the blood, then in the urine after being filtered by the kidneys. thus the body has been producing ketones for a while before you can detect them in the urine. children with diabetes highly recommends blood ketone testing over urine ketone testing.

since ketones in the blood can be detected well before ketones in the urine, there is the possibility to treat sooner than you would if you waited for urine testing to show a positive result. blood ketone testing can be easier for parents who have very young children with diabetes who do not always have the ability to urinate on command. also, being able to test with a finger stick eliminates the need to find a bathroom to test if you're away from home or when kids are at school.

two recent studies (february 2006) demonstrate clear medical benefit from blood ketone testing. the first study (diabetic medicine 23 (3), 278-284) showed a significant reduction in hospitalizations during sick days (38 vs. 75 per 100 patient days) for people who used blood ketone testing compared with urine ketones testing. staying out of the hospital is a very powerful argument for using blood ketone testing. the second study (diabetes technol ther. 2006 feb;8(1):67-75) showed that, for patients using insulin pumps, blood ketone testing could identify interruptions in insulin flow faster and more accurately than even blood glucose monitoring and could thus help pumpers prevent dka better than if they didn't use blood ketone testing

children with diabetes - hyperglycemia and ketone testing

there are two meters available for checking blood ketones: the precision xtra® and the novamax® plus. both meters also check blood glucose levels. because of the importance of identifying ketones as soon as possible, everyone with type 1 diabetes might want consider one of these meters for blood ketone testing, regardless of which blood glucose meter they use. for children and teens, particularly at school, testing for blood ketones rather than urine ketones is more convenient and easier to do, and therefore more likely to actually be used.

the following chart explains the blood ketone readings from both the precision xtra® and novamax®' plus:

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blood ketone reading indications

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above 1.5 mmol/l

readings above 1.5 mmol/l in the presence of hyperglycemia indicate that you may be at risk for developing diabetic ketoacidosis (dka). contact your healthcare provider immediately for advice. [/td]

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0.6 to 1.5 mmol/l

readings between 0.6 and 1.5 mmol/l may indicate the development of a problem that may require medical assistance. follow your healthcare provider's instructions.[/td]

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below 0.6 mmol/l

readings below 0.6 mmol/l are in the normal range.[/td]

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sources: documentation from the precision xtra® and novamax® plus

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[h=3]urine ketone testing

when to test for ketones if the blood sugar is > 240 mg/dl (13.3 mmol/l)¹, many diabetes teams recommend testing for ketones. this table offers guidelines for action based on the results of the ketones test.[/h]

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if ketones are:

blood: 0.6 to 1.5 mmol/l

urine: negative to small

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if ketones are:

blood: above 1.5 mmol/l

urine: moderate to large

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drink lots of water
keep drinking until urine is clear of ketones
take extra short-acting insulin as advised by your diabetes team
continue to check blood sugar and ketones

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drink lots of water
contact your diabetes team, as this level of ketones indicates a serious health condition
take extra short-acting insulin as advised by your diabetes team
continue to check blood sugar and ketones

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Arnu · Mar 14, 2012

We use the precision xtra ketone meter all the time. MUCH easier than urine strips. The strips are expensive, but so worth it. Plus most insurance companies cover them now.

84RN · Mar 18, 2012

I have two children with type 1, and we use the Precision Meter. The test strips are called Precision Xtra blood-ketone test strips, and come in a box of 10. They're expensive, but worth every penny, imho. There is no comparison for accuracy and immediate results between testing blood ketones and urine.

The meter itself can be used for both blood glucose and ketones, but uses different strips. Here is a link to the meter:

Precision Xtra® Blood Glucose and Ketone Monitoring System

This link talks about comparing blood vs urine ketone testing. I've found the Children With Diabetes website, it's forums and links to be invaluable in learning about diabetes management.

Blood vs. urine ketones [Archive] - Children with Diabetes Forums