First Ketone Check in....2.5 years?

Since we purchased a new fancy digital ketone meter for school, this morning after breakfast, Liam surged to over 300 (332 to be exact). I figured it would be an awesome time to check it out and see just how many ketones he has in his body when his sugars are this high. To my surprise (and to my relief), he only registered 0.1 on the meter while he was 332. The meter indicated being under .6 is ideal - anything over .6 basically, you’ve got ketones.

So, anyway, thought I’d post since this was our first ketone check in years and it was a relief to see no ketones with his BG this high. I’m sure this isn’t to say that EVERY TIME he’s over 300 he’ll have no ketones, but this check showed none so it made for a happy Papa.


I just did the same the other day. :slight_smile:
Highs do not necessarily correlate with ketones. It depends on the cause of the high. If the high is caused by misjudging carbohydrates, but there’s sufficient basal insulin so that the body can access glucose, then you can be 600 and have no ketones. But if the high is caused by lack of insulin to the point where the body can’t access glucose, you can be 250 and have high ketones.

In my opinion, that’s partly why ketone testing is valuable. It’ll tell you that the 250 will probably need a fair bit of extra insulin and may take forever to come down, and the 600 may start dropping like a rock as soon as it’s corrected. At least that’s the way ketones affect my blood sugar, in general.

I don’t test for ketones e

I generally don’t check for ketones with every high, especially after eating highs that are probably just caused by carbohydrates. (For example, this morning I had cereal for breakfast and then had chocolate shortly after…spiked to 14 mmol/L (250 mg/dl), but that’s not unexpected after that type of food!). But if I have an unexplained high or a high that is just not coming down, or if my infusion set is feeling irritated, or if I’m feeling ill at the time, then I’ll check for ketones.

I’m glad you got the meter. So much more useful than the ketone strips!


One of the factors I have always found significant to ketone development is time. A quick shot up to 300s or 400s may not show much for ketones if it’s resolved quickly, but solid days 180s or 200s may show significant ketones.


With the pee strips every time I have been over 250mg/dl the strips have reported ketones and every time I have been under they have not. Not that I test regularly.

This would be the $$55.79/$$-3 coupon offering from the land of Bezos? I kind of trust ketostix and the reviews on Amazon for the device in question suggest to me that it may not be accurate unless used very very carefully; like the blood-alcohol testers.

The advertising for the Amazon device says that there is a finger-strip (blood) test strip. I hadn’t heard of that and it sounds more promising. Does anyone have any links? I could only find pee strips on Amazon (maybe I didn’t read through sufficiently far through the interminable list.)


I bought the Precision Xtra Blood Glucose and Ketone Monitoring Meter Kit Bundle

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There are a bunch of (IMO) sketchy devices and meters aimed primarily at people following the keto diet. I wouldn’t trust any of these.

Abbott (same company who makes the FreeStyle Libre) has been making ketone meters aimed at people with Type 1 diabetes for at least the past 10-15 years. These are the only ones I’d use. Precision Xtra, Precision Neo (except in the US I’ve heard the Neo cannot measure ketones), and FreeStyle Libre (except maybe in the US?) can all measure blood ketones. You do need to buy specific ketone strips to use the ketone feature.


yep! We often have highs where the ketones are incredibly low, like 0.1. In the last two weeks, we’ve had one instance where Samson’s BG surged to 378 and he had ketones of 0.8 (we think it was a site failure after he swam). And another day where his blood sugar was well over 400 and his ketones when we checked were 0.1 (underestimated carbs in a dessert.) When highs are caused by mistimed or misjudged bolus insulin, ketones are unlikely. The tricky part is that you can sometimes have situations where you think you know why there’s a high, like “oh he ate pizza, no wonder he’s 280 4 hours after eating” when in fact the cause of the high is something else, like he’s getting sick or actually we forgot to clear out of the last screen after priming his pump, so it wasn’t delivering insulin.

That kind of thing. Glad you checked though! The goal is for it to always be in that low range, so hopefully every time you check it’s negative.


Thanks, the magic words that make Amazon start showing me the Abbott meter. I ordered the Precision Xtra meter (separate) with glucose and ketone strips; my prior experience with FreeStyle glucose measurement was that it was consistently under what I now get from my Contour USB meter.

I hadn’t realized the ketone tests even existed; does the Libre do them continuously or does it just have a test strip port on the controller?


@jbowler They don’t make a CKM (constant ketone monitoring) system.

The Precision Xtra meter takes 2 types of strips: Glucose and Ketones

I use the Freestyle Precision only for ketones, check BG with Contour Next

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The Libre reader has a test strip port that takes Precision glucose and ketone strips. These functions are separate from its glucose sensor function.

This was my setup, too. Precision meter for ketone testing, Contour Next for glucose testing. Now I’m using the Libre reader for ketones instead of the Precision.

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I used the Precision Xtra for years. I found it very reliable, both for BG and ketones.


I have never done a ketone check with blood. Can you give some information about the kit? Does it take a single blood drop and do BOTH your BG and ketones?

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These things have different test strips for BG and ketones. Both can be measured with the same meter, but not the same test strip.


You’d need to change out the strip, but assuming a big enough drop of blood that you are precariously balancing on your finger while swapping out strips, then yes, you could use the same blood drop :slight_smile:

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Well sure…

I guess using the same meter is a nice improvement.

But it would be cool to get both readings from the same strip at the same time. It would be like a “high” meter, you use specifically for your high BG’s.

Like if your Dex is telling you that you are over 200, you’d use that meter instead of your normal one, and automatically get both readings.

But strips would probably be too expensive that way.


Probably. In Canada each Freestyle Lite BG strip costs 78¢, but each Freestyle Precision ketone strip is $2.66. Which is one reason they come in boxes of 10 rather than 100 like the BG strips.


In Alberta it’s $30 with tax for a box of 10 ketone strips

Imagine how many cases of DKA could potentially be alleviated if your BG checks automatically reported ketones though…

Actually, scratch that, it’s probably not all that many :slight_smile:
There are probably many cases ofDKA that occur when people are not checking their numbers at all.


Yeah it makes no sense to me that they couldn’t just build the systems to give both numbers with a single strip/ blood drop.

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This is fascinating! Thanks for sharing!

And @ClaudnDaye I am so glad there were none! And glad school is going well!