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.

  • 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.

  • 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)

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.