Ketone Testing
Ketone testing involves checking how many ketones, or acids are in your bloodstream so you can make sure your body isn't burning fat instead of sugar and avoid a medical emergency, called ketoacidosis, which can lead to coma or death.
What are ketones?
Ketones are a type of acid that are left over when your body burns some of its own fat for fuel. Your body burns fat if it can't get enough sugar (glucose) to use for energy. When your body burns too much fat too quickly, there may be ketones in your blood. Ketones get removed from your bloodstream into your urine.
Why would my body have trouble using sugar?
Sugar is the first fuel your body burns for energy. To help move sugar from your bloodstream into body cells for fuel, your body needs insulin. Insulin is a hormone that is made in the pancreas. If there is too little insulin in the bloodstream to help the sugar get into cells, the body looks for other kinds of fuel to burn. When the body burns stored fat, ketones begin to build up in the body. Too many ketones in the bloodstream can lead to a serious problem called ketoacidosis. Without proper treatment, this can lead to coma or death.
Who should test for ketones?
People with type 1 diabetes develop ketones more easily than people with type 2 diabetes. Everyone with type 1 diabetes should test for ketones in their urine. People with type 2 diabetes are less likely to have problems with ketones, but everyone with diabetes should know about the warning signs and when to test. Ketone testing, like blood sugar testing, is very important. Finding ketones in your urine is a sign of trouble.
Ketone testing is often recommended for people with type 1 or type 2 who become pregnant or for women with gestational diabetes. Ketone testing may also be recommended for children with type 2 diabetes.
When should I test for ketones in my urine?
Your healthcare team will tell you when you should test for ketones. It is also a good idea to test if:
- Before breakfast. This is called the fasting blood sugar. Fasting means you have not had any food in 8 hours or more.
- Your blood sugar is 250 mg/dL or higher for two tests in a row.
- You are sick (even with a cold) because being sick can cause you to have ketones.
- You are vomiting or have diarrhea.
- You are under stress or are upset.
- You are pregnant.
How do I test for ketones in my urine?
Testing your urine for ketones is very easy. You can use a simple dip-and-read urine test strip. The test strip is dipped into a sample of your urine. If the color changes there are ketones in your urine.
You can get these strips at your drugstore. Ketone test strips are available in bottles and in individually foil-wrapped strips. They are sensitive to light and moisture, so it is a good idea to keep them stored in the container with the lid on tight. Always check the expiration date on the bottle or individually foil-wrapped strip, and do not use strips that are out-dated.
What do I do if my ketone test is positive?
If the results show trace or small amounts of ketones:
- Before breakfast. This is called the fasting blood sugar. Fasting means you have not had any food in 8 hours or more.
- Drink a glass of water every hour.
- Test your blood sugar and ketones every 3 to 4 hours.
- If your blood sugar is higher than 250 mg/dL and you have ketones, DO NOT exercise. Also, be sure to contact your healthcare team.
- If your blood sugar and ketones numbers are NOT going down after two tests, call your healthcare team.
If the results show moderate or high ketones:
- Call your doctor IMMEDIATELY.
- Drink a glass of water every hour.
Ketoacidosis can quickly develop into a very serious problem. Be sure to contact your healthcare professional if tests stay high or if you have any of the early signs of diabetic ketoacidosis (DKA).
Early signs of DKA include:
- Pain in your stomach.
- Nausea or vomiting.
- Rapid breathing.
- Fruity-smelling breath.
If you have any of these symptoms and have ketones in your urine, call your healthcare professional or go to the emergency room.