Ketone testing is often recommended for people with type 1 or type 2 who become pregnant or for women with gestational diabetes. Ketone testing may also be recommended for children with type 2 diabetes.
Your healthcare team will tell you when you should test for ketones. It is also a good idea to test if:

  • Before breakfast. This is called the fasting blood sugar. Fasting means you have not had any food in 8 hours or more 
  • Your blood sugar is 250 mg/dL or higher for two tests in a row. 
  • You are sick (even with a cold) because being sick can cause you to have ketones. 
  • You are vomiting or have diarrhea. 
  • You are under stress or are upset. 
  • You are pregnant. 
Testing your urine for ketones is very easy. You can use a simple dip-and-read urine test strip. The test strip is dipped into a sample of your urine. If the color changes there are ketones in your urine. You may want to try Ketostix® Reagent Strips, which are for testing only ketones in your urine. For testing your urine for both sugar and ketones, you may want to try Keto-Diastix® Reagent Strips.

You can get these strips at your drugstore. Ketone test strips are available in bottles and in individually foil-wrapped strips. They are sensitive to light and moisture, so it is a good idea to keep them stored in the container with the lid on tight. Always check the expiration date on the bottle or individually foil-wrapped strip, and do not use strips that are out-dated.

If the results show trace or small amounts of ketones:

    1. Before breakfast. This is called the fasting blood sugar. Fasting means you have not had any food in 8 hours or more 
    2. Drink a glass of water every hour. 
    3. Test your blood sugar and ketones every 3 to 4 hours. 
    4. If your blood sugar is higher than 250 mg/dL and you have ketones, DO NOT exercise. Also, be sure to contact your healthcare team. 
    5. If your blood sugar and ketones numbers are NOT going down after two tests, call your healthcare team. 
If the results show moderate or high ketones:
    1. Call your doctor IMMEDIATELY. 
    2. Drink a glass of water every hour. 
Ketoacidosis can quickly develop into a very serious problem. Be sure to contact your healthcare professional if tests stay high or if you have any of the early signs of diabetic ketoacidosis (DKA).
Early signs of DKA include:
  • Pain in your stomach 
  • Nausea or vomiting 
  • Rapid breathing 
  • Fruity-smelling breath 
If you have any of these symptoms and have ketones in your urine, call your healthcare professional or go to the emergency room.

 

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