Ketone body measurements can warn of the possibility of a serious diabetic complication, also known as diabetic ketoacidosis, or DKA.
Elevated levels of ketone bodies in the blood may indicate extremely high blood glucose levels. Too many ketones can trigger DKA, a clinical emergency.
Regular testing at home when ketone levels are too high may reveal the condition. Subsequently, insulin may be taken to lower blood glucose levels or other treatments may be used to prevent complications.
What exactly are ketone bodies?
Everyone has ketone bodies in their body, whether they have diabetes or not. Ketone bodies are chemicals in the liver.
When the body doesn’t have enough insulin to convert sugar (or glucose) into energy, it needs another source of energy, so the body replaces sugar with fat, and this creates ketone bodies.
The liver converts such fats into ketone bodies (an acid) and transports them to the bloodstream. Subsequently, muscles and other tissues can use ketone bodies as fuel.
For a non-diabetic person, this process does not cause abnormalities to occur. But when you have diabetes, things can get out of control and too many ketone bodies can accumulate in the blood. If ketone levels get too high, it can be life-threatening.
What types of people need ketone body testing?
If you have type 1 diabetes, you may need a ketone test.
If you have type 1 diabetes, you may need this test. In this type of diabetes, the immune system attacks and destroys the insulin-producing cells in the pancreas. If there is a lack of insulin, blood glucose levels will rise.
Ketone levels may also be significantly higher in people with type 2 diabetes, but they are less likely to occur than in type 1 diabetes.
Tests can show when ketone levels are elevated so that the condition can be treated before symptoms become apparent.
When should I get a ketone test?
Physicians may advise that ketone bodies should be tested when:
- Glucose above 250 mg/dl for two consecutive days;
- Illness or injury;
- Wanting to exercise and blood glucose levels above 250 mg/dl;
- In pregnancy.
Symptoms
You should also be tested if you begin to experience some of the following symptoms of DKA:
- Thirst;
- dry mouth;
- frequent urination;
- Fatigue;
- Dry or red skin;
- nausea, vomiting, stomach pain;
- Difficulty breathing;
- Fuzzy consciousness;
- Breathing as a fruity smell.
If blood glucose levels are extremely high or symptomatic, measure ketone levels every 4 to 6 hours. During pregnancy, testing should be done every morning before breakfast.
A urine or blood sample is required for ketone body measurement. Ask your doctor which sample is most appropriate.
Urine test
You can purchase ketone body testing supplies at your local pharmacy and perform the measurement yourself at home. A measurement can also be done at an office visit.
For the test, urine is drained into a clean container to obtain a sample and the following is then performed:
- Place the test strip into the sample (you can also place the strip under the urine stream).
- Gently shake the test strip.
- The test strip will change color and the instructions for use will tell how long it will take.
- Check the color of the test strip against the chart that came with the test kit. The color of the test strip will indicate the ketone level.
Blood test
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This test can also be done at home or in an office visit. To take a blood sample, your doctor will stick a thin needle into a vein in your arm to draw blood, or you can take blood from your fingertip.
You can also use home devices and blood test strips. Some blood glucose testers can also measure ketone levels.
For at-home measurements:
- Insert one of the blood ketone test strips into the instrument until it stops;
- Wash and dry your hands with soap and water;
- Insert the fingertip using the blood collection pen;
- Place a drop of blood into the hole of the test strip;
- Afterwards, check the result on the instrument.
How to interpret the test results?
The urine test will show in vivo:
- No ketone bodies;
- trace ketone bodies;
- moderate levels of ketone bodies;
- large amounts of ketone bodies.
Blood test results:
- Less than 0.6 mmol/L is normal;
- 0.6 to 1.0 mmol/L as slightly high;
- 1.0 to 3.0 mmol/L as moderately high;
- above 3.0 mmol/L is extremely high.
Record the results on a chart or in a journal. Subsequently, you can monitor your ketone levels over time.
A slightly high ketone level may mean that ketone bodies have started to accumulate in the body. An insulin injection may have been missed. Give an insulin injection as soon as possible and check again in a few hours.
Moderate to high ketone levels mean that DKA may be occurring. if ketone levels are extremely high, go to the emergency room immediately.
What do I need to do next?
Consult your physician to find out if you have a high level of ketones.
Consult your doctor to find out if you need to increase your insulin dose. He/she may recommend going to the nearest emergency room.
You can also try the following to lower ketone levels:
- Intake extra water to excrete ketone bodies from the body;
- Testing blood glucose every 3 to 4 hours;
- Do not exercise when blood glucose and ketone levels are high.
- Do not exercise when blood glucose and ketone levels are high.