P-361: Prevention keeps medical costs low: assessing awareness and access to home ketone testing among indians with type 1 diabetes (T1D)
M Dhingra, A Virmani, S Arora, S Puri, H Kohli, S ChughAbstract
Introduction
People with T1D (PwD) are at risk of diabetic ketoacidosis (DKA), which if mitigated by timely action based on home ketone testing, saves effort & cost (important as medical expenses often out-of-pocket). Reliable, inexpensive blood & urine ketone testing supplies are available in India.
Objectives
To assess awareness, access & practices related to ketone testing among Indians with T1D, to identify gaps requiring targeted education.
Methods
Brief English & Hindi surveys covering demographics, T1D duration, DKA history, knowledge about blood ketones (BK) & urine ketones (UK), home availability of test supplies, testing practices, & discussion of sick day rules with healthcare providers (HCP) were circulated in Feb-Apr 2026 via WhatsApp groups of T1D communities across India.
Results
493 voluntary self-responses were received from across India: North 188 (38%), South 34%, West 16%, East 7%, Central India 5%; 405 (82.2%) in English; Hindi 17.8%; females 54.4%. Age of PwD: 1-10y: 144 (29.2%), 11-20y: 238 (48.3%), 21-30y: 52 (10.5%), 31-63y: 56 (11.4%), missing data: 3 (0.6%). T1D duration: 0-2y: 63 (12.8%), 3-5y: 162 (32.9%), 6-10y: 117 (23.7%), 10-28y 96 (19.5%), missing data 55 (11.2%). 267 (54.2%) had experienced DKA. 137 (27.8%) marked unsure of symptoms of raised ketones; 104 (21.1%) marked unsure when ketones should be tested; 55 (11.2%) marked unsure what to do when ketones raised. At home: 32 (6.4%) had BK + UK supplies; 81 (16.4%) had BK; 154 (37.7%) had UK; 226 (45.8%) had no ketone supplies; 97 (19.7%) had never tested. 161 (32.7%) knew BK are more accurate. Sick day rules had not been discussed with HCP by 142 (28.8%).
Conclusions
DKA frequency was high. Awareness about ketones was high though many not taught by HCP (likely due to frequent group discussions). Yet almost half the PwD kept no home supplies, increasing risk of costly admissions. HCP may need to discuss sick day rules with every PwD, reinforce frequently, check if home supplies bought, and emphasize potential cost saving.