January 23, 2017
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Education needed for ketone testing in type 1 diabetes

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Ketone self-monitoring rates were high among very young children, whereas older adults infrequently checked their ketones, even when blood glucose was high, according to findings published in Diabetes Care.

Anastasia Albanese-O’Neill, PhD, ARNP, CDE, assistant professor in the College of Nursing at the University of Florida Health, and colleagues evaluated data from the T1D Exchange Clinic Registry on 2,995 children aged 4 to 12 years and adults aged 18 to 89 years (mean age, 27 years) with type 1 diabetes (mean duration, 18 years) to determine ketone-monitoring behaviors.

Anastasia Albanese-O'Neil
Anastasia Albanese-O’Neill

All participants completed an online questionnaire about their behaviors between October and November 2015.

Among the participants, 62% reported keeping urine ketone test strips at home, 18% had a blood ketone meter at home and 32% reported no testing supplies. According to questionnaire results, 20% of participants “never” and 30% of participants “rarely” checked their ketones.

Fifteen percent of all participants, 53% aged 6 years and younger, 33% aged 6 to 12 years, 17% aged 18 to 25 years, 7% aged 26 to 49 years and 11% aged at least 50 years reported “always” checking their ketones of checking “most of the time” when their glucose levels were near 300 mg/dL.

Among participants reporting on checking ketones when nauseated and/or vomiting, 21% of all participants, 68% of those younger than 6 years, 57% of those aged 6 to 12 years, 23% or those aged 18 to 25 years, 9% of those aged 26 to 49 years and 9% of those aged at least 50 years reported “always” checking, whereas 38% of all participants reported they “never” checked. Nearly half (45%) of participants reported “never” checking ketones when they had a fever.

“Although reported ketone self-monitoring among very young children with [type 1 diabetes] (or their parent caregivers) adhered most closely to clinical guidelines, ketone monitoring among adult participants was infrequent when blood glucose was high, when nauseated and/or vomiting, and when fever was detected,” the researchers wrote. “Overall, the reported rate of ketone monitoring is low, which suggests a need for more robust diabetes education related to this self-care behavior for patients with established [type 1 diabetes].” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.