May 04, 2017
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 more rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well.
What are the symptoms of ketone buildup?
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:
If you don’t get treatment, the symptoms can progress to:
You should always seek immediate medical attention if your ketone levels are high.
How are ketones tested?
You can use blood or urine tests to measure your ketone levels. 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:
To perform a urine test, you will urinate into a clean container and dip the test strip into the urine. If a child 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.
Doctors often recommend that people who’ve just been diagnosed with diabetes test their ketones twice daily.
While individual testing may vary, in general, results for ketone testing are labeled in the following way:
An abnormal result may also be due to:
Call your doctor if your ketones are low to moderate, and seek emergency medical attention if your ketone levels are high to very high.
Ketones can make your blood acidic. Acidic blood can cause a serious condition known as diabetic ketoacidosis (DKA).
If you don’t get treatment for high ketone levels, DKA can occur. The most serious effects of DKA include:
This is why it’s important to have a plan of action in the event that your ketone levels become too high.
Careful management of diabetes is the key to preventing high ketone levels. Do the following to keep your blood sugar levels healthy and ketone production to a minimum:
Your doctor will recommend how frequently you should check your blood sugar levels, but this is typically four to six times per day. You should check your blood sugar more often if:
Managing your carbohydrate intake and insulin dosage is vital for managing diabetes. Be sure to talk to your registered dietitian if you need help managing your diet.
Sometimes, moderate ketone levels can be treated before they worsen. A doctor can help you create a plan for when your ketone levels get too high, such as administering additional insulin and drinking more water. Have a sick day plan set so you can refer to it as needed.
Keep ketone testing kits with you at home and when you travel so that you have a fast way to check your ketone levels.
Diabetes management takes constant vigilance to ensure your insulin regimen and eating plan is working effectively. The medication and insulin combination that works best varies depending on the person. You should talk to your doctor if you’re concerned about your ketone levels being frequently high.
Likewise, if you are drinking a lot of fluids, the ketone concentration will be lower ("false negative").