What Are Ketones?
Ketones are a type of acid that is left over when your body burns its own fat for fuel. 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. Ketones get removed from your bloodstream through the urine. But, ketones can build up in the bloodstream, and, when too many ketones build up it the bloodstream, it can lead to a serious problem called ketoacidosis.
Who Should Test For Ketones?
Because insulin helps the body use sugar for energy instead of fat, insulin prevents the buildup of ketones. People with type 1 diabetes develop ketones more easily than people with type 2 diabetes because people with type 1 diabetes often have less insulin made by their own body than people with type 2 diabetes. Everyone with type 1 diabetes should know how to test for ketones in their urine and be instructed by their healthcare team when to check (e.g., during illness and times of stress). 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 that you need to take action to avoid getting into trouble.
Ketone testing is often recommended for people with type 1 or type 2 diabetes who become pregnant or for women with gestational diabetes.
When Should I Test For Ketones In My Urine?
Your healthcare team will tell you when you should test for ketones. It is often a good idea to test if:
- Your blood sugar is 250 mg/dL (13.9 mmol/L) 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.
These are times that you may need more insulin than you usually do, so you may be at risk for developing ketones during these situations.
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, like Ketostix™ from Bayer. 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 on individually foil-wrapped strips, and do not use strips that are outdated. Some urine sticks test for other substances in the urine and may be confusing to read. It may be easiest to get urine sticks that only check for ketones.
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 immediately or go to the emergency room.
Hemoglobin A1c
Hemoglobin A1c or A1c is a blood test that is done every 2-3 months and gives you an overall idea of your blood sugar control over that time period. Daily blood testing gives you information about how your blood sugar responds to your meal plan, activity, illness, medicines, and other aspects of your daily plan. The A1c is more of an overview and approximates your average blood sugar. It is very helpful information and it is important to discuss both your daily blood testing results and your A1c with your healthcare team.
It is a good idea to set a target range for your A1c with your healthcare provider, just like you set goals for your daily blood sugars. People without diabetes generally have an A1c below 6%. Some healthcare guidelines recommend trying to maintain your A1c below 7% and others suggest below 6.5%, but this is an individual decision between you and your healthcare provider.