Ketone testing - type 1 diabetes

Home testing for ketones in the urine is a very useful tool for people with type 1 diabetes. Ketones are a type of acid and are produced when the body burns fat for energy instead of glucose, due to not enough insulin. Ketones are likely with illness, injury and/or high blood glucose levels. Checking for ketones in urine allows for measures to be taken early if detected in more than trace amounts. Having high levels of ketones can lead to diabetic ketoacidosis (DKA), a life-threatening condition, so early treatment is important.

When should I test for ketones?

If you have type 1 diabetes you should test for ketones in your urine when:

• your blood glucose is going up (at any level) and you are feeling unwell
• your blood glucose is greater than 17mmol/L and it is not coming down (even if you feel well)
• you are unable to test your blood glucose but you feel unwell
• you develop abdominal pain and/or nausea and vomiting.

What ketone sticks should I use?

For most purposes the individually foil-wrapped ketone sticks that you can buy from many chemists and also through Diabetes Supplies Ltd are the best. They are called 'Ketostix' and are made by Bayer. Because they are foil-wrapped they are less likely to go off. Also it is easy to carry two or three strips in your blood glucose meter case. This way if you are out, you will have them with you if you need them. Remember also to carry the colour guide chart with them, so if you do need to test you are able to read the result!

Check expiry date

You should check the expiry date on your sticks every now and again. This avoids having expired sticks at the time you most need to know what your ketone levels are.

Managing ketone levels

Having ketone testing sticks and knowing how to use them enables you to detect when your ketone levels are increasing. Once you know this is happening, then you are able to manage it. Also see high blood glucose in Type 1 diabetes for more on ketones and management.

Original material provided by Diabetes New Zealand, 2008. Edited by everybody, August 2011.