Ketone Testing
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
Ketones are a chemical produced by your body when it is not able to use glucose as its source of energy due to a lack of insulin. When glucose can’t be used as energy, your body will start breaking down fat for energy instead and this is when ketones are produced. This is a short term solution for the body as over time the level of ketones will increase and can become dangerously high. If this happens, diabetic ketoacidosis (DKA) can develop which can be life threatening.
Having ketones is more common in Type 1 than Type 2 diabetes. You may have continued high glucose readings because you are finding it difficult to manage your diabetes, have missed a few injections, you are ill, have an infection, or for any other reason. It is important to test your level of ketones if you have Type 1 diabetes and your glucose readings are above 15mmols/L. Checking for ketones may be advised by your healthcare professional as part of your diabetes management program.
You can test your level of ketones by using urine sticks or blood test strips with a meter that can test for ketones. Not all meters have the ability to test for ketones and you will need separate test strips for ketones to do this.
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.
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Blood ketone level |
What you should do |
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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. |
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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. |
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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.
How to test for ketones?
Comparing home urine tests and blood tests from measuring ketone levels
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Testing blood ketones with FreeStyle Optium™ and FreeStyle Optium Neo |
Testing urine ketones |
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Immediacy |
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Measures β-hydroxybutyrate - the predominant blood ketone |
Measures acetoacetate - a poor indicator of overall blood ketone levels |
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Direct measurement of ketones in the circulation |
Indirect measurement of ketones in the circulation |
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Indicates current ketone levels, allowing prompt action |
Indicates level of ketones in blood 2-4 hours previously |
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Increased accuracy |
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Advanced biosensor technology minimises interference from common drugs |
False positive results with captopril. False negative results with high levels of vitamin C |
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Unaffected by levels of fluid intake (unless severely dehydrated) |
High fluid intake may dilute urine leading to false negatives. Low fluid intake or dehydration may lead to false positives |
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Accuracy protected by individually foil wrapped test strips |
Infrequently used test strips exposed to air degrade over time |
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Practicality and acceptability |
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Direct reading on large digital display |
Relies on visual colour comparison |
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Quantitative, accurate assessment |
Indicates only 'large', 'moderate', 'small' or 'trace' |
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A familiar and well-accepted blood testing method |
Unfamiliar and less socially acceptable urine testing method |
