A normal person with a negative qualitative ketone body test and a positive urinary ketone body 2+ is in ketosis. When glucose metabolism is impaired or diabetic acidosis occurs, ketone bodies are produced faster than they are consumed, resulting in ketonuria.
Ketone bodies in the urine consist of acetone, acetoacetic acid, and β-hydroxybutyric acid, which are products of fat metabolism in the body and are produced minimally under normal conditions. A negative qualitative test for ketone bodies in normal subjects and a positive urinary ketone body 2+ is ketosis. When glucose metabolism is impaired or diabetic acidosis occurs, ketone bodies are produced at a greater rate than they are consumed, causing ketonuria.
If the patient is diabetic themselves and their blood glucose is not well controlled and they need to retest their blood glucose or blood ketone bodies, consider the possibility of diabetic ketoacidosis. If the patient is not usually diabetic, it may be caused by recent low eating, hunger, or not eating in the morning. In severe cases, patients may experience polyuria, fatigue, loss of appetite, nausea, vomiting, abdominal pain, headache, irritability, and drowsiness.
The first step in treatment is to eliminate the causative factors and prevent complications. Next, appropriate fluid supplementation and small doses of insulin should be treated by continuous intravenous drip until the ketone body disappears. Those with water loss status should be rehydrated as soon as possible to restore blood volume, which helps to lower blood glucose and clear ketone bodies. Correct the electrolyte balance and ensure the normal level of blood potassium, and patients with severe acidosis should be treated with appropriate alkaline supplementation. Usually pay attention to hydration, develop regular diet and living habits, eat more fresh vegetables and fruits, keep your mood relaxed and don’t stay up late.