Ketones and Ketoacidosis
Ketones are a chemical produced by your body when, due to a lack of insulin, it is not able to use glucose as its source of energy, and instead start breaking down fat.
What are ketones?
The body produces ketones by breaking down fat when blood glucose drops. In people who do not have diabetes, a low level of ketones is normal, and not harmful. They appear if you haven't eaten for a while and after prolonged exercise. In people without diabetes, glucose, insulin and ketones work together to supply the body with the energy it needs.
In diabetes, ketones are produced when blood glucose is not well controlled. Ketones in the urine are a sign that your body is using fat for energy instead of using glucose. This may be because not enough insulin is available to take the glucose from the blood stream to the cells to use for energy.
Ask your healthcare professional when you need to check for ketones. This is important if you have Type 1 diabetes. You may be advised to check for ketones when your blood glucose is more than 13.3mmol/L, or if you feel unwell.
What is ketoacidosis?
Ketones are acidic. A low level of ketones will not have much effect, but as the levels increase, the blood will become more acidic. The name for this is ketoacidosis.
The first signs of ketoacidosis are increased urination and thirst, while later symptoms include nausea and vomiting, which can lead to dehydration.
At very high ketone levels. ketoacidosis require emergency medical treatment. If left untreated it can be fatal.
Blood ketone test results
Normal blood ketone levels are slightly different from person to person. This table will help you decide if you need to do anything and what you should do. Remember, it is far better to be careful, so if you are not sure contact your diabetes care team straightaway.
Blood ketone level |
What you should do |
Below 0.6 mmol/L |
Readings below 0.6 mmol/L are in the normal range. Follow your healthcare professional's advice before making any changes to your diabetes medication programme. |
Between 0.6 and 1.5 mmol/L |
Readings in this range, with a blood glucose level higher than 13.9 mmol/L, may indicate the development of a problem. Follow your healthcare professional's instructions. |
More than 1.5 mmol/L |
Readings above 1.5 mmol/L, with a blood glucose level higher than 16.7 mmol/L, suggest you may be at risk of developing diabetic ketoacidosis (DKA). |
Abbott Diabetes Care produces a meter that can test for ketones. You should discuss ketones with your GP or nurse if you have further questions.