Issue: March 2017
January 23, 2017
2 min read
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Education needed for ketone testing in type 1 diabetes

Issue: March 2017
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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.

Perspective from

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.