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Research Project: Nutritional Metabolism in Mothers, Infants, and Children

Location: Children's Nutrition Research Center

Title: Poor adherence to ketone testing in patients with Type 1 Diabetes

item ALBANESE-O'NEILL, ANASTASIA - University Of Florida
item WU, MENGDI - Jaeb Center For Health Research
item MILLER, KELLEE - Jaeb Center For Health Research
item JACOBSEN, LAURA - University Of Florida
item HALLER, MICHAEL - University Of Florida
item SCHATZ, DESMOND - University Of Florida
item MOREY, HAYMOND - Children'S Nutrition Research Center (CNRC)

Submitted to: Diabetes Care
Publication Type: Review Article
Publication Acceptance Date: 12/26/2016
Publication Date: 1/18/2017
Citation: Albanese-O'Neill, A., Wu, M., Miller, K.M., Jacobsen, L., Haller, M.J., Schatz, D., Morey, H. 2017. Poor adherence to ketone testing in patients with Type 1 Diabetes. Diabetes Care. doi:10.2337/dc16-2620.

Interpretive Summary:

Technical Abstract: Diabetic ketoacidosis (DKA) is an acute, still common, and preventable complication of type 1 diabetes (T1D) associated with increased health care costs, morbidity, and mortality. Clinical recommendations advise self-monitoring of ketones in people with T1D during hyperglycemia and illness to allow for early diagnosis of ketonemia or ketonuria and to reduce the risk of DKA. The potential benefits of self-monitoring of ketones can only be realized if ketone monitoring and management are conducted as advised. The purpose of this study was to characterize ketone monitoring behaviors in both children and adults with T1D who completed an online questionnaire during October and November 2015 as part of the T1D Exchange Clinic Registry. Although reported ketone self-monitoring among very young children with T1D (or their parent caregivers) adhered most closely to clinical guidelines, ketone monitoring among adult participants was infrequent when blood glucose was high, when nauseated and/or vomiting, and when fever was detected. Overall, the reported rate of ketone monitoring is low, which suggests a need for more robust diabetes education related to this self-care behavior for patients with established T1D.