Summary: The blood ketone meter is maybe one of the best kept secrets in managing type 1 diabetes in children. It’s as simple as a blood sugar check, can be done while they are sleeping, and doesn’t require urine like ketostix do. The results are real-time and don’t lag by two hours like urine tests do.
I can extol the virtues of the blood ketone meter for use with younger children at home and especially at school.
If there is one tool that I wish we had been told about at diagnosis, but didn’t find out about until much later, it’s the blood ketone meter. Seriously. Can’t imagine diabetes care without it now!
For one thing, ketones in urine are about two hours behind. What does that mean? If you check for ketones with urine at 2:00 pm, it is really telling you what the ketone levels were at 12:00 pm. You have to wait two hours to see what ketones are right now. A blood ketone meter gives real time results. In other words, it tells you what ketone levels are right now. No waiting.
This comes in handy when your child is vomiting! Like when Q vomited right after her bedtime snack and I couldn’t keep her blood sugar up, yet she was developing ketones. Remember that 2:00 am trip to the ER?
Here’s the issue we ran into when Q was in kindergarten: Per her 504 plan, she needs to have her ketones checked with any blood sugar over 300 mg/dL and we are to be called. With the urine strips I had to leave work to come to school to try to help her pee on the stick for two reasons. First, the assistant principal who did much of her diabetes care was a male and he wasn’t going to help her pee in a cup. Second, the school nurse was only there for about 20 minutes at lunch time and I would rather Q spend the time right after lunch running around the playground bringing down that high BG than sitting in the bathroom with the nurse trying to pee in said cup. (At home we used to use the training potty for her to pee in when she had high blood sugars.)
Our protocol at school has changed dramatically for the better when she has a blood sugar over 300 mg/dL:
- Wash hands with soap and water and repeat blood sugar test. (We’ve had some false highs in the past from residue on fingers.)
- If the blood sugar is still over 300 mg/dL, check for ketones with the blood ketone meter.
- Call me to advise on if a correction is needed, how much, and when to recheck.
I’ve missed considerably less work using this system, that’s for sure!
Blood ketone strips are covered by some insurance companies and not covered by others. And they are expensive with insurance and crazy expensive without. But for us, they are worth the expense. Some insurance plans cover these under the pharmacy benefit and some cover them under durable medical equipment (DME).
There are now two choices in blood ketone meters. The Abbott Precision Xtra and the Novo Max Plus. Novo Max usually has an offer to get a free blood ketone meter.
And as a side note, we keep a ketone meter at home, at school, and in our preparedness kit. I think we have three of them and have never had to pay for the meter. We got a prescription for the meter itself and there has never been a copay when we’ve picked it up from the pharmacy. And we all know that companies practically give away the meters because they are making their money off of the test strips!
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