DKA & Ketones

Why and when should I test my urine for ketones?

Why should I test for ketones?

Being sick can increase your risk of going into DKA.Ketones in urine indicate a body in distress. Knowing if you are producing ketones can help your doctor determine if you need adjustments to your insulin doses, timing of insulin, different insulin, or in some cases, if you require hospitalization.

Ketones in the urine may indicate diabetic ketoacidosis (DKA), which untreated, can lead to serious, even fatal consequences. Home glucose monitors cannot determine if a person is in DKA, and although DKA typically occurs in blood glucose levels that remain over 240 mg/dL, there are circumstances where it can occur at much lower levels and even over a matter of hours.

What is diabetic ketoacidosis (DKA)?

Diabetic Ketoacidosis (DKA) – When not enough insulin is present blood glucose runs too high. The body begins to use fat stores as an energy source. Ketones, a byproduct of burned fat, are produced and can quickly reach dangerous levels. High ketones indicate that a person may be in diabetic ketoacidosis which can result in coma or death and usually requires hospitalization to become stable again. You should never attempt to treat DKA without specific instructions from your physician.

When should I test for ketones?

Your blood glucose monitor probably has a feature that says “check ketones” when your blood glucose reading is 240 mg/dL or higher. Some meters are preprogrammed to alert you that your blood glucose levels are high enough that you could be in danger. “Check ketones” simply is your meter suggesting that it might be wise to check your urine to see if you are producing ketones.

Your doctor may offer other guidelines for when to test for ketones including:

  • any time blood glucose levels are over 240 mg/dL
  • during illness (especially dehydrating problems like vomiting and diarrhea), or stressful situations
  • any time you become dehydrated or are urinating frequently
  • randomly the first few weeks after diagnosis when diabetic ketosis (DKA) is most likely to recur.

When should I call my doctor?

Your physician will let you know when he/she wants you to call. However, most ask that you call any time that your blood glucose is high more than twice in a row, during illness, or any time that your urine tests positive in the moderate to heavy range for ketones.

Sources:
Diabetes New Zealand
Joslin Diabetes Center; Ketone testing
Web MD; Ketones