When to check for ketones:

• If blood glucose is higher than 300 mg/dL twice in a row using a meter or more than 2 hours if using a continuous glucose monitor.
• If your child feels ill. Ketones may develop even if blood glucose is not elevated.
• Before exercise if blood glucose is higher than 250 mg/dL. If ketones are present, exercise should be delayed.
• If ketones are present at any time, even if only trace amounts, continue to check ketones every 2 hours until they are negative.
  • Drinking extra water or other sugar free liquids is important to help prevent dehydration and to help clear ketones.

How to check ketones:

Have your child pee in a clean container and put the test strip in the urine sample. If you child wears diapers, dip a cotton ball in a wet diaper then squeeze a drop of urine onto the test stripe or dab the wet cotton ball on the strip. Follow the package directions and compare the color on the strip to the color chart on the package.

When to call our office/telenurse:

• If ketones are moderate-large. Extra insulin may be recommended to help clear ketones.
• If your child is unable to eat or drink for more than two meals in a row.
• If your child has ketones along with stomach pain, nausea, vomiting, or sweet, fruity-smelling breath. These may be symptoms of ketoacidosis.
• If your child has altered mental status or rapid or labored breathing, go to the emergency room immediately.