Ketones in Urine

The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well.

Symptoms

If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include:

• a dry mouth
• blood sugar levels greater than 240 milligrams per deciliter (mg/dL)
• strong thirst
• frequent urination

If you don’t get treatment, the symptoms can progress to:

• confusion
• extreme fatigue
• flushed skin
• a fruity breath odor
• nausea
• vomiting
• stomach pain
• trouble breathing

You should always seek immediate medical attention if your ketone levels are high.

Testing for ketones

Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs:

• Your blood sugar is higher than 240 mg/dL.
• You have symptoms of DKA.
• You feel sick or nauseated, regardless of your blood sugar reading.

To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a parent can usually press the stick to their child’s wet diaper to test for ketones. Urine testing strips contain special chemicals that change colors when they react with ketones. You can interpret the test results by comparing the test strip to the color chart on the package. When you have ketones present in your urine, it’s called ketonuria.

An at-home meter is available to test for blood ketones. This is performed in a similar way to a finger-stick glucose test. You prick your finger with a needle and place a small drop of blood onto the testing area. Doctors often recommend that people who’ve just received a diabetes diagnosis test their ketones twice daily.

Treating high ketone levels can immediately help you avoid hospitalization for DKA. Work with your doctor to decide what you need to do to help manage moderate ketone levels. If you’re unable to treat at home or if your levels continue to rise, you’ll need to receive medical treatment.