Keytones and kids that are old enough to manage at school

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Permalink Reply by kelly on October 31, 2009 at 8:18am

HAHA!! i think i am the ONLY one in our house that changes the lancet drum in our 'poker'!!
i do it once a day, since it has 5 'needles' in a drum. (we use the aviva accu-chek with the pen 'poker').
we test about 8-10 times a day, so i figure 1/2 of those get a clean needle, and thats darn good!!!
heaven forbid ben goes to daycare...it never gets done there, no matter how many times i tell them to check it and change it! so, i just change it in the mornings.

isn't it fun to spill our little 'secrets'...

big hugs and high fives for all the hard work we do :)

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Permalink Reply by Elizabeth on October 31, 2009 at 1:05pm

I read somewhere you can get over 300 uses of the lancet before it gets too dull to draw blood--haven't tested that, but I think it's fair to say I'm not exactly religious about changing it

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Permalink Reply by Cheryl Gravelle on October 1, 2009 at 11:19am

Stephanie,

David keeps what we call an emergency kit in his backpack, separate from his test meter. It contains a bottle of ketostix, vial of insulin, 3 syringes, alcohol packets, spare resevoir, spare infusion set for his pump, set of batteries for his test meter, spare AAA battery for his pump, medic alert card, a business card with all of my coordinates and two quarters for a payphone. It all fits into a small plastic box with one of the good 4-sided lock lids, just a little longer than a sandwich box. Even though it is always handy, he forgets to check for ketones routinely as part of a high BG correction, and he is 16 years old.

You will have to look at how the numbers convert, but normal BG in mmol/l is 4 to 7, 10 mmol/l 2 hours after eating and 8 mmol/l going to bed. He is supposed to test for ketones every time his blood glucose exceeds 17 mmol/l. His kit is handy but he often skips the ketone test before automatically treating high BG's. If he does not feel well, and has a high BG over 10, he will do both. Earlier this week David tested for ketones with a 14.8 reading simply because he did not feel well at the same time as the high BG. His ketones were slightly elevated so the early catch to correct probably saved him from having a really bad day.

Cheryl

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Permalink Reply by Olivia Martin on October 1, 2009 at 1:12pm

My 11 year old daughter carries the foil strips with her to school, but she only checks if she is 250+ two times in a row or when she feels like she might be coming down with a cold/flu (regardless of what her BG is). When getting sick is the only time she has had Ketones so we are pretty on top of it at any sign of illness... and usually her BG is great when Ketones have been present.

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Permalink Reply by Vicki S on October 1, 2009 at 8:02pm

We rarely check for ketones. If she has a high number for more than 2 checks in a row or highs and she is complaining of feeling ill - other than that we just don;t check anymore. We have NEVER had ketones - even at dx. She had a 14 A1c and still no ketones . . .My dh has never had them either - (well except at his dx - but he was an adult at dx and in college and put off going to the doctor until he about passed out and was in DKA.)

We keep ketostiks at school and I think they make her check if she is over 300 - but we have a daily morning spike in the upper 200's and low 300's daily at 9:30ish - we have adjusted her basals, her i:c and what she eats and still a spike - but by lunch she is normal range. So I do not worry about ketones then . . .

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Permalink Reply by Jan on October 3, 2009 at 1:04pm

She has only had trace ketones, no matter how high the BS, even if it takes a few hours to come down. We always give more insulin, increased temp basal and water when high. We put the increased temp basal on if there is no movement in two hours.

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Permalink Reply by Julie on October 3, 2009 at 6:20pm

Hi Stephanie,
We test for ketones after two high (250+) numbers in a row. My son is 11 and pumps. He has had trace/small ketones before and it seems like once they come it makes everything so much more stressful for me. He gripes more about having to pee on the stick than pricking his finger...go figure!

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Permalink Reply by Renata Pellino-Porter on October 10, 2009 at 12:37am

I think you have to go with what your experience is. Most people here have stated they know they don't have to worry unless they have had highs repeatedly. But that is because they have experience in testing and getting no results. I will say that we fall into that category too. Unless they have repetitive highs...I don't force the kids to test. However, that's because I have learned that they read negative if it's just one high number.

On a note with school nurses. (and this is my personal opinion) You definitely want them on your side, so you have to be delicate. However, you also need to be firm in this is how you manage your son's diabetes. You dictate to them, not visa versa. My son is also an epileptic and have learned through the years of both kids being in school with diseases that I had to stand strong and would not let anyone make me feel guilty about how I managed my children's care. Boy howdy have they tried. There were many years when I was told that I was to follow their rules, until a light bulb went off in my head. "wait a minute, this is my damn kid..." and that was that. From now on, even if it's the same nurse year after year, I walk in with a plan and all their paperwork filled out. (It's usualy online in the States.) Then when we sit down for the appointment I have set up, I go over what their part is as the school nurse. Ever since then my relationships with the school nurses have been of one of trust and partnership which is how it should be.

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Permalink Reply by Tanya Paul on October 23, 2009 at 2:22pm

I am new to this site and new to diabetes, but I feel so much better now. Our endo said that we should test ketones when Becky is over 250. She was diagnosed 09/09/09. We haven't checked ketones in a very long time. Most of the time, if she is over 250, I know exactly why. She is 8 (will be 9 in December). She has brought home a fun size tootsie roll because she was scared to eat it. She has eaten stuff and knew better, but then tells us when the number is high.

We were also told that it is okay to just change the lancet every few days. Becky says that she can tell when one needs to be changed. I was questioning the "clean needle" thing and was told not to worry about it. Just don't let her drop her lancet into a dirty puddle. If that happens, then change it.

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Permalink Reply by Lorraine on October 23, 2009 at 2:41pm

Hi Tanya and welcome to TuDiabetes.
I'm sorry about your daughter's diagnosis, but so glad you found us all here. It is comforting to know what others do as a practical matter. Checking for ketones and changing lancets are both important things to do. I would think particularly since your daughter is relatively new to diabetes, it might be prudent to exercise a greater level of diligence particularly when it comes to ketones. In fact, I myself should probably exercise a greater level of diligence in that area.

All the best to you and Becky.

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Permalink Reply by MelissaBL on October 23, 2009 at 3:30pm

You can have ketones even if you "know why" the sugar is high. I have developed ketones from missing basal insulin for a couple hours when I know that the reason was that my pod came loose. I've developed them from underestimating the carbs on a serving of tacos. I've developed them from not considering the fat effect of the food I'm eating. So it's still a good idea to test for ketones when the blood sugar is high. Any large ketones that do not come down over the course of a few hours might send her to the ER.

I haven't changed my lancet since before Christmas. When I was a kid, I carried four lancets a day and changed them religiously. But as an adult, I've learned that even my CDEs don't change their lancets often. If you prefer every few days, go for it. If you prefer the "I'll change it when it starts hurting method" or the "I'll change it when it no longer draws blood," then those are okay, too. :)

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