Measuring blood ketones

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Blood ketone testing may prove even more useful than urine ketone testing during illness. It's done with a finger stick drop of blood applied to a blood ketone test strip. At present, only two home meters provide blood ketone readings: the Precision Xtra Blood Glucose Meter (refer to Chapter 7) and the CardioChek Blood Testing Device (which can test blood glucose, blood ketones, cholesterol, HDL cholesterol, and triglycerides when the proper test strip is used).

The advantage of blood ketone testing is similar to the advantage of blood glucose testing: Ketones rise in the blood earlier than in the urine, so the earlier the ketones are noted to be abnormal, the earlier treatment can proceed. A study published in Diabetic Medicine in March 2006 showed a large reduction in patient time spent in the hospital when blood ketone testing was done compared to urine ketone testing. Another advantage is the ease of obtaining a drop of blood compared with urine from a small child.

The disadvantages at present are the cost (about $3 to $4 per test compared to less than 20 cents for urine testing) and the fact that only two meters can do the test.

If you test for ketones with the blood test, the interpretation for adults and children is as follows:

¡^ Above 1.5 mmol/L with high (greater than 250 mg/dl) blood glucose means that your child is at high risk to develop diabetic ketoacidosis. Call your doctor immediately.

¡^ 0.6 to 1.5 mmol/L with high blood glucose means less risk. Treat with fluids and insulin, and let your doctor know that your child is showing this level.

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