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This survey about ketone testing is now closed. Thanks to all who have participated.

1. Do you have a child with diabetes?

Yes
No [Goto question End]
I don't know [Goto question End]

2. Does your child have type 1 or type 2 diabetes?

Type 1
Type 2
I don't know

3. How old is your child with diabetes?

Less than 5
5-9
10-14
15-18
19 or older

4. How familiar are you with monitoring your child's glucose or blood sugar level?

Very familiar
Somewhat familiar
Not too familiar
Not at all familier

5. Another important level to monitor in children with Type 1 diabetes is ketones. How much have you heard about ketone levels as it relates to children with diabetes?

A great deal
Some
Not too much
Nothing at all [Goto question End]

6. How familiar are you with the process of monitoring ketone levels as a way to help control diabetes?

Very familiar
Somewhat familiar
Not too familiar
Not at all familiar

7. How important is it to monitor the ketone levels of a child with Type 1 diabetes?

Very important
Somewhat important
Not too important
Not at all important
Don't know

8. Why is it important to check ketone levels? (check all that apply)

High ketone levels mean not enough insulin is available.
Ketones have acid properties that can make a person very sick, causing a condition called ketoacidosis (diabetic coma).
You need to test for ketones if a child with Type 1 diabetes is sick (even vomiting once).
It is an important test if a child's blood sugar is high.
Other

9. Which of the following is most likely to cause high ketone levels?

Missing insulin injections
Illness
Reduced activity
Diet
Emotional stress
All of the above
Don't know

10. How many times has your child visited the emergency room in the past year due to complications resulting from elevated ketone levels?

None
1-2
3-4
5-6
More than 6

11. How many times has your child missed school due to the complications resulting from elevated ketone levels?

None
1-2
3-4
5-6
More than 6
Not in school

12. How familiar are you with a condition related to Type I diabetes called diabetic ketoacidosis or DKA?

Very familiar
Somewhat familiar
Not too familiar
Not at all familiar [Goto question 15]
Don't know

13. How serious is ketoacidosis or DKA for children with Type 1 diabetes?

Very serious
Somewhat serious
Not too serious
Not serious at all
Don't know

14. How important is ketone testing in the prevention of DKA?

Very important
Somewhat important
Not too important
Not important at all
Don't know

15. On average, how often do you test your child's ketone levels?

Daily
A few times a week
About once a week
Once or twice a month
Every few months
Once or twice a year
Never [Goto question 18]

16. Do you test your child's ketone levels more often during a time of illness?

Yes
No
Don't know

17. Which do you use more frequently for testing ketone levels, blood testing or urine testing?

Blood test
Urine test
Don't know

18. Please select whether you agree or disagree with each of the following statements:

	Strongly Agree	Somewhat Agree	Neither Agree nor Disagree	Somewhat Disagree	Strongly Disagree	Don't know
Blood ketone testing is more convenient than urine ketone testing
Blood ketone testing is more accurate than urine ketone testing
Using a monitoring method that provides a real-time indication of my child’s current ketone status is important

19. How likely are you to test your child's urine ketone levels at home with a dipstick test during times of good health?

Very likely
Somewhat likely
Not too likely
Not likely at all
Don't know

20. How likely are you to test your child's urine ketone levels at home with a dipstick test during times of illness?

Very likely
Somewhat likely
Not too likely
Not likely at all
Don't know

21. Did you know that there is a portable handheld meter available for testing blood ketone levels at home?

Yes
No
Don't know

22. If you knew about the home blood ketone meter, have you used it?

Yes
No
Don't know

23. If you had this product, that is, a portable handheld meter available for testing blood ketone levels, how likely would you be to test your child's blood ketone levels at home during times of good health?

Very likely
Somewhat likely
Not too likely
Not likely at all
Don't know

24. If you had a portable handheld meter available for testing blood ketone levels, how likely would you be to test your child's blood ketone levels at home during times of illness?

Very likely
Somewhat likely
Not too likely
Not likely at all
Don't know

25. If a portable handheld meter tested both blood ketone and blood glucose levels, how likely would you be to use this device for your child's daily glucose monitoring?

Very likely
Somehwat likely
Not too likely
Don't know

26. Are you male or female?

Male
Female

27. How many children do you have?

1
2
3
4
5
6 or more

28. Do you or your spouse have type 1 or type 2 diabetes?

Type 1
Type 2
Both
Neither

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Last Updated: Wednesday August 02, 2006 22:53:15
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