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Checking Ketone Levels
In people with diabetes, a buildup of ketones in the blood can lead to diabetic ketoacidosis, a potentially life-threatening condition. Learn m...

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What Are Ketones?

Ketone bodies are acids made when your body begins using fat instead of carbohydrates for energy. When there is not enough insulin to get sugar from the blood and into the cells, the body turns to fat for energy. When fat is broken down, ketone bodies are made and can accumulate in the body. High levels of ketones are toxic to the body. The condition is called ketoacidosis.

Ketones are most likely to show up when there is not enough insulin in the body. This can happen if people who have type 1 diabetes don’t take insulin or don’t take enough to meet higher demands, such as during illness or stress, or when a pump gets clogged or unattached. It can also happen in people with type 2 diabetes who are insulin-deficient if they get sick.

You may have ketone bodies without having ketoacidosis if your diet is very low in carbohydrates or very low in calories and nutrients.

Are Ketones a Sign of a Problem?

If your blood glucose is within a safe range and you are losing weight, the presence of ketones may be perfectly normal. However, if you have diabetes, it’s important that you keep a watchful eye on both your ketones and your blood glucose even as you lose weight.

Trace amounts of ketones may mean that your body is in the beginning stages of building up stores. In that case, test again in several hours to see if the amount changes. If it goes up, make an appointment to see your doctor.

Moderate to large ketone numbers may mean your diabetes is out of control. As part of your diabetes-management program, you and your healthcare provider should develop a plan for what to do if your ketone levels are high. But if you don’t have such a plan, be sure to contact your doctor immediately. High ketone levels can be a sign of a potentially dangerous situation. Ketones alter the chemical balance of your blood. If left undiagnosed and untreated, they can poison the body.

How Do You Test for Ketones?

A urine test is the recommended way to test for ketones.

If you are conducting an at-home test and begin noticing ketones, contact your healthcare provider. The presence, not just the level of ketones, may be important.

When Should You Test?

Your doctor or healthcare provider will likely help you understand when it’s important to check for ketones, basing recommendations on your health history. Typically, it is suggested that you test for ketones whenever:

  • your blood glucose number goes over 300
  • your skin is flushed or loses color
  • you experience vomiting, nausea, or abdominal pain
  • you are sick—illness, infections, and injuries can cause sudden high blood glucose
  • you feel lethargic (have very little energy) and/or confused
  • you experience dry mouth or are thirstier than usual
  • you have a difficult time breathing
  • your breath smells “fruity”

Pregnant women may be told to test each morning before breakfast and/or any time the blood glucose reading goes above 200.

If you experience one or more of these conditions, check your ketone level. Call your doctor if symptoms persist, your ketone levels are above average or high, or you begin having additional problems.

Diabetic Ketoacidosis

Ketones build up in the blood and urine as fats and are broken down for energy. In high levels, ketones can be very dangerous and even poisonous. This serious condition is known as ketoacidosis and, if left untreated, can lead to diabetic coma or even death. The symptoms of ketoacidosis can be confused with others (such as the flu or a stomach virus), so be sure to talk to your doctor about a plan for when to test for ketones.

Written by: Rachel Nall, RN, BSN, CCRN
Edited by:
Medically Reviewed by: Debra Sullivan, PhD, MSN, RN, CNE, COI
Published: Jul 11, 2016
Published By: Healthline Networks, Inc.
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