Test Overview
A ketone test checks for ketones in your blood or urine. Ketones are substances that are made when the body breaks down fat for energy. Normally, your body gets the energy it needs from carbohydrate in your diet. But stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with sugar (glucose) for energy or if your body can't use blood sugar (glucose) properly.
Ketones can be tested in a laboratory or on the go using home blood or urine tests.
Why It Is Done
A blood test analyzed by a laboratory is the most accurate method of measuring ketones. It is recommended for all people with diabetes whenever symptoms of illness are present, such as nausea, vomiting, or abdominal pain. These symptoms often happen with high blood sugar and may mean you have diabetic ketoacidosis, a potentially life-threatening condition.
Home blood or urine ketone tests are done to:
- Monitor a person who has diabetes, especially when that person is sick.
- Monitor a person on a low-carbohydrate diet and/or high-fat diet.
- Monitor a person who is not able to eat due to anorexia or fasting, who is vomiting a lot, and/or who has diarrhea.
- Monitor a person who is sick.
- Monitor a pregnant woman who has diabetes or has developed gestational diabetes.
How To Prepare
No special preparation is needed before having this test.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form .
How It Is Done
Blood test by a laboratory
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Apply a gauze pad or cotton ball over the needle site as the needle is removed.
- Apply pressure to the site and then a bandage.
Blood test at home
Some home blood sugar meters can also measure blood ketones. You use the same finger-prick method that you use to measure blood sugar.
Urine test
- Collect a urine sample in a clean container.
- Follow the manufacturer's directions on the bottle of test strips or tablets.
- Avoid getting toilet paper, pubic hair, stool, menstrual blood, or other foreign matter in the urine sample.
How It Feels
Blood test by a laboratory
The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.
Blood test at home
Your finger may feel sore after pricking it for a drop of blood for the test.
Urine test
There is normally no discomfort involved with collecting a urine sample.
Risks
Blood test by a laboratory
There is very little risk of a problem from having blood drawn from a vein.
- You may develop a small bruise at the puncture site. You can reduce the risk of bruising by keeping pressure on the site for several minutes after the needle is withdrawn.
- In rare cases, the vein may become inflamed after the blood sample is taken. This condition is called phlebitis and is usually treated with a warm compress applied several times daily.
Blood test at home
There is very little risk of complications from testing your blood for ketones with a home blood sugar meter.
Urine test
There are no risks linked with collecting a urine sample.
Results
A ketone test checks for substances made when the body breaks down fat for energy (ketones).
Ketones
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Normal:
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There are no ketones in your blood or urine.
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Abnormal:
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Ketones are present in your blood or urine.
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Blood test at home
Home blood sugar meters that also test for ketones display results on the meter's screen.
In people who have diabetes, blood ketones are expected to be lower than 0.6 mmol/L.
Urine test
Ketones are present in the urine if:
- The test strip changes colour after dipping it into the urine.
- The urine changes colour after placing the test tablet in it.
You usually compare the colour of the test strip or urine to a chart to find out if ketones are present.
High values
You may have ketones if you:
- Have poorly controlled diabetes or diabetic ketoacidosis.
- Are on a very low-carbohydrate or high-fat diet.
- Are starving or have an eating disorder, including disorders that result in poor nutrition such as anorexia nervosa or bulimia, alcohol use disorder, or poisoning from drinking rubbing alcohol (isopropanol).
- Have not eaten (fasted) for 18 hours or longer.
- Are pregnant. Some women have low levels of ketones during pregnancy and this does not affect the fetus. But a moderate or high amount of ketones in a pregnant woman may harm the fetus and may be an indication of gestational diabetes.
The level of ketones, and not just the presence of ketones, may be important to your doctor as well. Many conditions can change ketone levels. Fasting usually causes only mild increases in the level. But ketone levels in diabetic ketoacidosis are much higher. Your doctor will discuss any significant abnormal results with you in relation to your symptoms and past health.
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
- Taking medicines, such as:
- Levodopa, such as Sinemet or Larodopa.
- Valproate, such as Depakene.
- Vitamin C (ascorbic acid), when taken in large amounts.
- Waiting a long time after collecting the urine to test it.
What To Think About
Your doctor may recommend you test for ketones if you have diabetes and you have any of the following conditions:
- You have a blood sugar level that stays higher than the level the doctor has set for you, for example, 17.0 mmol/L for two or more readings.
- You are pregnant.
- You are sick or feeling very stressed.
- You have symptoms of diabetic ketoacidosis.
References
Other Works Consulted
- Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Credits
Current as of: August 31, 2020
Author: Healthwise Staff
Medical Review: E. Gregory Thompson MD - Internal Medicine
Brian D. O'Brien MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Alan C. Dalkin MD - Endocrinology
Matthew I. Kim MD - Endocrinology
David C.W. Lau MD, PhD, FRCPC - Endocrinology
