This literally PISSES me OFF...

OK...maybe I shouldn't even be "talking" about this, but I am constantly surprised at this when "chatting" with other type 1 families (especially those families with a YOUNG type 1 child). I have ran into this "thing" that BUGS me time-and-time again professionally and personally.

WHY DOESN'T EVERYONE HAVE BLOOD KETONE MONITORS PEOPLE!?

REALLY?

OK, I do "get it" if it is totally COST related...I am aware of the Diabetes "HAVES" vs. Diabetes "HAVE NOTs"...but so many times I run into people that don't even KNOW that you can check ketones by testing the blood - ARGHHHHhhh (can you tell this frustrates me?).

OK Ineed to step back and CLARIFY why this frustrates me...I think I may be sounding angry at the family with type 1...you guys know me, I love other families dealing with this high maintenance beast of a disease ... I am irritated that physicians did not inform them about this method of checking ketones at home.

I can see it if insurance doesn't cover it. You thought blood glucose test strips were expensive (at about a $1.00 a pop). Blood Ketone test strips run about $3.75 a pop. When Joe got really sick a few years ago we went through $100.00 (out-of-pocket) of ketone strips in a few days. This was a total "newbie" oversight on my part. Now I make sure and re-order them when re-filling insulin, lancets, and blood sugar test strips so that I always have a "back-up" supply for "Sick Days". Urine Ketone testing is MUCH cheaper at about $0.16 a dip.

Click here for a LOooNG article regarding blood vs. ketone management ...blah...blah...blah.... my eyes started crossing a couple of pages into this 20 something page article.

AND

Here is an AWESOME page on the above mentioned dilemma on the Children With Diabetes site... PLEASE READ THIS by clicking HERE if you are testing ketones by dipping urine.

If you don't have the time or simply just don't want to read either article...here is the "quick and dirty"...

Why? You may ask do I have such a STRONG opinion on the whole KETONE TESTING method. Well first off, the urine sitting in your child's bladder is "OLD NEWs" and doesn't reflect what is going on RIGHT NOW. Also, the urine ketones have been "filtered" by the kidneys and may be reflected as falsely low or "negative". What if your child doesn't have to pee? What if your child is sleeping? The last thing you want to do is wake the sleeping kid up to pee to check ketones. Furthermore, the margin for "operator" error is greater with the urine dip sticks as they expire quickly and they cannot be exposed to air for a prolonged period of time. Also, one must "read" the urine-dipped-stick according to the "specific" instructions written on the packaging. With the Precision Xtra blood ketone checking device you get REAL TIME data with a prick of the finger (I know I make the "pricking of the finger" sound like no biggie). If you are "on your game" you simply squeeze out enough blood to test ketones while you are doing a blood sugar check.

So the LONG and the SHORT OF IT:

Urine Ketone testing -> Cheaper, accuracy is questionable, access to a kid that will pee on command - ah yeah - good luck.

Blood Ketone testing -> More expensive (check with insurance provider), more accurate, real time data, and let's face it the kid will always bleed.
Some of the messy details of our "day-in-the-life"... Sorry for the RANT.