If you have diabetes, chances are you have had your blood or urine tested for ketones. When your body doesn’t have enough insulin to absorb glucose, it breaks down fat for energy and produces chemicals called ketones as a byproduct.
Everyone produces ketone bodies, but if you have diabetes, you are at greater risk of building up ketones in your blood, which can lead to diabetic ketoacidosis (DKA), a condition that can make you sick. In extreme cases, diabetic ketoacidosis can lead to coma and death.
People with type 1 diabetes are more likely to develop diabetic ketoacidosis, but people with type 2 diabetes are also at risk. Because DKA can be life-threatening, it is critical to know when and how to test for ketone bodies in the blood and how to interpret the results.
When to Test for Ketones
If you have diabetes, there are some health changes you should be aware of. Your healthcare provider will tell you which conditions and symptoms warrant a ketone test. Some of these include:
- blood sugar level over 240 mg/dl
- symptoms such as nausea, vomiting, or abdominal pain
- sick (for example, cold or flu)
- feeling tired
- feeling thirsty or dry mouth
- flushing of the skin
- Smells “fruity”
- Confused or “bewildered”
- Recently diagnosed diabetes
All About Ketones and Diabetes
How to Test Your Blood for Ketones
Testing urine is one way to detect the presence of ketone bodies, but blood tests are considered more accurate.
Blood tests can be done in a lab, but there are also handy home meters that you can test right away if you have symptoms of ketoacidosis. Two popular home blood glucose and ketone meter combinations are Abbott Labs’ Precision Xtra Meter and Nova Biomedical’s Nova Max Plus.
When purchasing test strips, keep in mind that each meter requires its own test strips; they are not interchangeable. When you receive your purchase and test blood, please note the expiration date on the test strip. Expired test strips will not give accurate results.
The U.S. Food and Drug Administration (FDA) warns against buying previously owned test strips, as you may be buying products that have not been stored properly and may have expired. The FDA also warned against buying strips that have not yet been approved for sale in the United States.
To get an accurate reading, follow these step-by-step instructions.
- Load the needle into the lancet pen according to the package directions.
- Wash hands with soap and dry.
- Remove the test strip from the package and insert it into the meter.
- Hold the lancet pen to the side of your fingertip and press the button.
- Squeeze your finger lightly to get a drop of blood. You will need a big drop to load the strips properly. After doing it two or three times, you’ll know how much blood you need. With a Precision meter, you will need a larger drop of blood than when testing your blood sugar (even with the same meter). The Precision meter also requires a larger blood drop than the Nova Max (1.5 microliters vs. 0.03 microliters)
- Touch the end of the test strip to the drop of blood until it fills the small opening and the meter registers.
- Wait for the meter to give you a reading (just a few seconds).
- Document your results.
Interpret your blood test results
Scopes have been created to help you interpret your reading. Your results will fall into one of three ranges:
- Below 0.6 mmol/L: If your reading is below 0.6, it is in the normal range.
- 0.6 to 1.5 mmol/L: If your values are in this range, you have ketone bodies in your blood, which may be problematic if left untreated. You should contact your healthcare provider and follow his or her instructions.
- Above 1.5 mmol/L: A reading above 1.5 indicates a greater risk of developing ketoacidosis. You should contact your healthcare provider immediately for advice.
Medical experts recommend that a ketone blood test reading of 3.0 mmol/L may require immediate treatment at the nearest emergency room.
If you have diabetes, you should discuss home blood ketone testing with your healthcare provider to find out if and when testing is recommended in your situation. Ketone testing is especially important during illness. If caught early, diabetic ketoacidosis can be reversed with intravenous fluids and insulin.