Diabetes Self-Management Articles

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Diabetic Ketoacidosis
A Preventable Crisis

by Jan Chait

Several brands of urine ketone strips are available, including Ketostix, Keto-Diastix (which also check for glucose in the urine), and Clinistix. Ask your pharmacist if ketone strips are available individually wrapped in foil packets. While the initial cost is higher, they last longer than the ones that are loosely packaged in vials. However, they may need to be specially ordered.

When to check for ketones
Don’t wait for an emergency to happen before learning when to check for ketones and what to do if you detect ketones in your blood or urine. Talk to your doctor or diabetes educator in advance. In general, ketones should be checked for in the following situations:

  • You have an unexplained blood glucose level over 250 mg/dl two times in a row.
  • You are sick (with a cold, a sore throat, the flu, a stomach virus, suspected food poisoning, or anything else that makes you feel ill).
  • You are planning to exercise and your blood glucose level is over 250 mg/dl.
  • You have symptoms of DKA, such as increased urination, a stomachache, and dry mouth. (Click here for more about symptoms of DKA.)
  • Your insulin pump has malfunctioned, causing an interruption in insulin delivery.
  • You have experienced a traumatic stress.
  • You are pregnant, in which case you should check for ketones every morning before breakfast and any time your blood glucose level is over 250 mg/dl. Pregnant women who have ketones in the morning are advised to eat more carbohydrate late in the evening or during the night.

If you detect ketones in your blood or urine, general treatment guidelines include drinking plenty of water or other calorie-free fluids to help flush ketones out of the body, taking insulin to bring your blood glucose level down, and rechecking both your blood glucose level and ketone level every three to four hours. Additional insulin may be needed to bring your blood glucose level down if ketones are present.

If ketone levels are not coming down, or are going up, treat the incident as a medical emergency and go to a hospital.

With proper vigilance, having ketones appear in your blood or urine won’t escalate into a medical emergency, and your life won’t be in peril.

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Also in this article:
Hyperosmolar Hyperglycemic State
Signs and Symptoms



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