Went to the endo. Dd is doing great and her A1c is way down, thank you Nightscout. The nurse/educator lady asked what scripts we needed. When she asked if we needed ketone strips I didn't want to admit the truth but had to say that we NEVER check ketones. We did at first but dd never gets ketones. The few times she did, bad pump site, I didn't have to check since I already knew she must have ketones--crazy high bs and vomiting. So the question is, what would I do differently if dd had ketones? Basically, with a high bs, I'm just pushing insulin and fluids and keep checking until it comes down. Switch out the pump site and keept dosing and drinking until it's down. Ketone or not does not change that treatment. I suppose if she were sick and had ketones with a normal bs I would push juice and insulin, but if she were sick, I'd probably do that anyway. If she were sick and throwing up, and couldn't keep food down, that would be a trip to the doc anyway. So, not to be a lazy D mom, since I do know how and why ketones come aobut and the danger of them and the need and ways to clear them, I just see that the treatment for high bs or sickness seems to be the same with or without ketones. Drink, dose, check bg, repeat, repeat, repeat.