Keytones and kids that are old enough to manage at school

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Permalink Reply by MelissaBL on October 1, 2009 at 10:11am

We tested religiously the first few years, any time I was sick or over 250, but then fell off the wagon. I think I stopped testing in early high school and didn't start again until age 28. *blush*

I agree that we all should test more often, of course, but I think that life gets in the way and it never seems quite as urgent as knowing that blood glucose value or making sure you're dosing the right amount of insulin. The truth is that it's complacent of us to think that way and DKA could take any type 1 without a lot of notice. =/ Does that thought make me test often? No. But it does make me test more than I used to.

You might consider the individually wrapped-in-foil ketostix. They don't expire as quickly as the bottled version and you can know you have them on hand in a pinch. It'd be great to have one in your purse that you can just hand him and send him off to the bathroom with when you're out and about. I keep one wrapped strip in my meter pouch at all times.

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Permalink Reply by Stephanie on October 1, 2009 at 10:17am

All of it is so true. But when it's a little foil stick that I can carry and he can easily carry in his pouch it seems silly not to be doing it. I don't know why I didn't think of just keeping one in his pouch. He actually is very interested in those sticks, checking to see if they change color.

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Permalink Reply by MelissaBL on October 1, 2009 at 10:22am

In case you have trouble finding them...

I've found them online (can't ever seem to find them at the pharmacy). I have seen them at edgepark.com, diabetesandmore.com, dlife.com, and several other places. You might also give your local pharmacy the NDC number for the foil-wrapped strips and see if you can order them: NDC 0193-2640-20.

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Permalink Reply by SFMAMA on October 1, 2009 at 10:33am

We take a similar approach. Since Abbie's only ever had ketones when she's sick, we only test if she's had several high readings in a row, or a high that we have a hard time getting down. And even those are negative or trace.

At school, because ketone testing is in the care plan that our DR signed, they insist that she test if she's ever over 300. I've had the school nurse lecture before as well and have learned to just nod and smile.

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Permalink Reply by sheryl lauria on October 1, 2009 at 10:38am

My son has only had diabetes for 1 year. At school we test keytones because we have to. At home he tests when its abnormally high like if the test before was around 100 then the next one is 300. Usually we get zero to trace. Only once we got a small to moderate and that week he had a slight cold. Lately his numbers have been really high and it is driving me crazy. We just go along with our lives as normally as we can. Its a part of us now.

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Permalink Reply by Natasha Bowlds on October 1, 2009 at 10:43am

We test whenever my son is over 250 - but only since he's been pumping. Our CDE wanted us to catch it early if his pump wasn't delivering or something had gone wrong. Before that she said that that if we pretty much knew why he was high we didn't have to worry about testing. We also got the precision meter so we could test with a finger prick - more accurate and easier to do in my opinion. Do you have one of those?

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Permalink Reply by Stephanie on October 1, 2009 at 11:01am

Yes, we have a precision meter but rarely use it now. We used it more when he was a toddler, he's almost 11 now and actually has fun with the sticks.

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Permalink Reply by Lorraine on October 1, 2009 at 11:00am

I will only test if there is a sustained high for hours. Even then he has never been positive for ketones when high. Caleb does not have ketone strips at school. If he were high for an extended period of time I would go in anyway.

The reason I don't test otherwise is because it would not change my course of action. I would still deliver the same insulin dose and encourage liquids.

The only time Caleb was slightly postive for ketones was when he was ill, sustaining lows and not eating. I would still check under those circumstances as well. The body can produce ketones not only because of high blood sugars but also because it isn't getting enough insulin into the system, which was the case with Caleb when he wasn't eating and the illness caused lows, not highs.

Knock wood, he has not had a significant illness since that one time.

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Permalink Reply by Stephanie on October 1, 2009 at 11:04am

I'm glad to see we're not doing much different. I don't have it in the plan to test his keytones at school because we are next door to the school and if there is ever a need I will bring him home and test him. The dr. was ok with this so that's how it was written. The nurse today was filling in for the nurse we've been with for 6 years so it's probably why it's the first time I've had the question. I think I still like the idea of having a foil sealed strip in his pouch just in case anyway.

And yes, SFMAMA, we are very good at the smiling and noding!

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Permalink Reply by Lorraine on October 1, 2009 at 11:12am

lol - I like the nod and smile comment! Yes we do get good at that don't we (as painful as it can be sometimes). I can't be the only one who does not change the lancet after every finger stick can I? That always seems to raise an eyebrow.

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Permalink Reply by Olivia Martin on October 1, 2009 at 1:08pm

My dad, who is type 2 and only tests every few days, was shocked that I didn't change my daughter's lancet every time we tested. At diagnosis, the nurse at Children's told me we only need to change it every 2-3 days so that's what we have always done. It does seem to go against the clean needle theory though:-)

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Permalink Reply by Stephanie on October 1, 2009 at 1:16pm

Change the lancet? What's that? only kidding, we religiously changed it the first few years every time. Not any more.

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