Testing Urine for Ketones

Occasionally, patients with diabetes will need to test their urine for ketones. Ketones are toxic byproducts your body produces when you don't have enough insulin and your body burns fat instead of glucose.

When ketones build up in the blood faster than the body can expel them through urine, a dangerous condition known as diabetic ketoacidosis (DKA) can occur.

Symptoms of DKA include:

Frequent urination or extreme and frequent thirst
Fatigue
Nausea or vomiting
Muscle stiffness or aches
Sweet or fruity smelling breath
Confusion that may progress into a coma

You can test a small amount of urine with a special test strip to determine if you have abnormally high levels of ketones in your blood. There are several different ketone testing strips available. Your doctor or diabetes educator can help you decide which is right for you.

You should test for ketones if you:

There are many reasons why you might have a high level of ketones:

Are pregnant (every day before breakfast)
Have type 1 diabetes and your glucose readings are over 240 mg/dL for more than two hours
Are very thirsty, have a dry mouth, and urinate often
Have a high fever, vomiting, or diarrhea
Have been under high physical or psychological stress
Are frequently exhausted or feel weak
Have breath that smells fruity
Have difficulty breathing
Have blurry vision
Have trouble concentrating

Illness

Lack of insulin
Too little food
Hypoglycemia (low blood glucose leads the body to break down fat)
Hyperglycemia (high blood glucose is a sign that insulin is not available to let glucose into cells, so the body breaks down fat instead)

What to do when your Ketones are high

High ketone levels are a serious medical condition that should be taken seriously. Call your doctor or diabetes educator if you experience symptoms of DKA. You may be advised to drink plenty of water, eat some high-carbohydrate food, and/or take additional insulin. Often it is not possible to reverse DKA at home, so hospitalization might be required.