Ketones and Diabetes

Blood Glucose Monitoring SystemBlood Glucose Monitoring System

What are ketones?4

The cells in the body use glucose, a simple form of sugar, for energy.

To move the glucose from the blood into the cells we need insulin. Insulin is a hormone normally released by the pancreas into the blood stream after a meal.

A couple of hours after a meal, blood glucose levels fall and the amount of insulin released by pancreas is reduced. If the person does not eat for a while, insulin levels remain low and that triggers the release of fat to be used as an alternative energy source.

The fat released into the blood is taken up by the liver where it is broken down and processed into ketones. Our bodies can use ketones for energy. It is normal for people to have a small amount of ketones in the blood from time to time if they are eating less or increase their energy output by exercising.

Elevated ketone levels usually occur in people with type 1 diabetes when there are inadequate levels of insulin in their body. This is less common in people diagnosed with type 2 diabetes.

Abbott Diabetes Care, 666 Doncaster Road, Doncaster, Victoria 3108, Australia.www.abbottdiabetescare.com.au ABN 95 000 180 389 MSE120606021946

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Blood Glucose Monitoring System

n Tests both blood glucose and blood ketonesn Technology used in hospitals worldwide2

n Foil wrapped strips reduces the risk of contamination3

n CoPilot Compatible – download up to 450 results

One Meter, Twice the Benefits

1. Craig ME, Twigg SM, Donaghue KC, Cheung NW, Cameron FJ, Conn J, Jenkins AJ, Silink M, for the Australian Type 1 Diabetes Guidelines Expert Advisory Group. National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults, Ch 17 pp 123-135, Australian Government Department of Health and Ageing, Canberra 2011. 2. Based on purchases made by hospitals worldwide. Data on file. 3. T M Wallace and D R Matthews, Recent advances in the monitoring and management of diabetic ketoacidosis, Q J Med 2004; 97:773–780 4. Diabetes Australia website - Ketoacidosis: http://www.diabetesaustralia.com.au/en/Understanding-Diabetes/What-is-Diabetes/Ketoacidosis-/ 5. Diabetes Australia website - Diabetes and Pregnancy: http://www.diabetesaustralia.com.au/en/Understanding-Diabetes/What-is-Diabetes/Gestational-Diabetes-/ 6. Sick Day Management for Type 1 Diabetes (Teens and Adults), Saskatchewan Ministry of Health, Nov 2011 7. http://www.diabetesaustralia.com.au/en/Understanding-Diabetes/What-is-Diabetes/Hyperglycaemia/

FreeStyle Optium range of products are used in the testing or monitoring of blood glucose and blood ketone levels for people diagnosed with diabetes.

FreeStyle and related brand marks are trademarks of Abbott Diabetes Care Inc. in various jurisdictions. Information contained herein is for distribution outside of the USA only. Full references provided on request from Abbott Diabetes Care.

People with diabetes with elevated blood ketones should seek medical advice. Ask your health professional how a FreeStyle Optium may assist you. Always read the label and use only as directed.

For more information call Abbott Diabetes Care Customer Service on 1800 801 478 or visit www.abbottdiabetescare.com.au

How do I interpret results?1

Persistently elevated blood glucose levels and moderate to high ketone levels are a cause for concern. This may mean that you do not have enough insulin for your current needs.

Your diabetes specialist or diabetes educator may give you further instructions based on your blood glucose and blood ketone results.

Remember, it is important that you stick to your recommended insulin doses, even if you feel sick or unable to tolerate your normal diet. A common mistake people with diagnosed diabetes make is to stop taking their recommended insulin dose when sick, due to concerns their blood glucose levels may drop. Always check your blood glucose levels when your body is under stress and adjust your insulin doses accordingly.

If you are sick and not able eat your normal diet try to have some easily consumed foods that contain sugar such as regular soft drinks, toast and jelly. Remember, it is very important that you keep hydrated by drinking water when you are unwell.6

If your blood or urine ketone levels remain elevated or are increasing contact your diabetes specialist or educator immediately. It is better to act early and seek advice. If you cannot contact them, visit your local hospital emergency department where your condition can be properly assessed.

Elevated ketones may result in a medical emergency.4 However it can often be avoided if you check your ketone levels early and seek appropriate advice. Remember to discuss a sick day management plan with your diabetes healthcare team.

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Ketones & type 1 diabetes1

Type 1 diabetes is a condition where the pancreas no longer makes insulin.

Type 1 diabetes normally develops in childhood or young adulthood. People with type 1 diabetes must replace the insulin they no longer produce by injection or by insulin pump.

When a person with type 1 diabetes does not get enough insulin, the glucose in the blood can no longer get into the cells causing the person to become increasingly tired and fatigued. As the level of glucose in the blood rises abnormally high, some is removed from the body in the urine. As urine output increases, the person can become increasingly thirsty and dehydrated.

If the insulin deficit is too great, fat will be released into the blood as an alternative fuel. This can happen rapidly in type 1 diabetes if the ketones build up faster than they can be used.4

The combination of dehydration and abnormally high levels of ketones in the blood may result in a medical emergency.4 Talk to your diabetes specialist or diabetes educator about what increased ketone levels may mean for you.

How do I measure ketones?1

Ketones can be measured directly in the blood but they also pass out of the body in the urine.

To measure ketones in the urine you dip a piece of colour – reacting paper into the urine and assess the degree of colour change against a colour chart.

The FreeStyle Optium blood glucose monitoring system can measure both blood glucose and blood ketone levels. The blood ketone check is a more accurate3 and convenient test, performed in the same way that blood glucose levels are checked.

Using a FreeStyle Optium as your routine glucose meter offers the ability to check for ketones at anytime.

Ketone Action PlanWork with your healthcare team to determine your ketone action plan.

Blood Glucose Monitoring System

When should I measure for ketones?1

Ketones usually occur in people with type 1 diabetes when their insulin levels are inadequate.

This could be because you missed a dose of insulin or your insulin pump is not working properly. Often it is because you are unwell or have an injury or infection. Stress will cause an increase in the body’s insulin requirements and if these additional requirements are not met, an insulin deficit will develop.7

Hormonal changes and increased demands during pregnancy may also increase the amount of ketone formation.

If you have type 1 diabetes and find you are pregnant or are planning a pregnancy, it is vital you contact your diabetes team as soon as possible.5 Make sure that you keep some ketone testing equipment at home and understand how to use it.

If you have type 1 diabetes you should have a ‘sick day’ management plan that has been discussed with your diabetes healthcare team.6

If blood glucose levels remain more than 15mmol/L or your ketones are above 1mmol/L contact your diabetes healthcare team for further advice.

Blood Ketone Level Insulin Dosage

Below 0.6 mmol/L

Normal: Follow your healthcare professional’s advice before making any changes to your diabetes medication program.

0.6 to 1.5 mmol/L

Medium: May indicate the development of a problem that may require medical assistance. Follow your healthcare professional’s instructions.

Above 1.5 mmol/L

High: Contact your healthcare professional immediately for advice.