What are ketones?

The human body primarily runs on glucose.  When the body is low on glucose, or if you have diabetes and don’t have enough insulin to help the cells absorb the glucose, your body starts breaking down fats for energy.  Ketones are by-products of the breakdown of fatty acids of the liver.  The breakdown of fat for fuel and the creation of ketones is a normal process for everyone.

What happens if ketone levels get too high in the blood?

In a person, without diabetes, insulin and other hormones prevent the ketone levels in the blood from getting too high.  However, people with diabetes are at risk of ketone build-up in their blood.

High levels of ketones can make the blood acidic.  If left untreated, people with type 1 diabetes are at risk for developing a condition called Diabetic Ketoacidosis (DKA).  While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well.  DKA is a serious condition that can lead to diabetic coma or even death.

The most serious effects of DKA include:

What are the warning signs of Diabetic Ketoacidosis (DKA)?

DKA usually develops slowly.  If vomiting occurs, this life-threatening condition can develop in a few hours.  Early symptoms include the following:

• Thirst or a very dry mouth.
• Frequent urination.
• High blood glucose (blood sugar) levels.
• High levels of ketones in the urine.

Then, other symptoms appear:

• Constantly feeling tired.
• Dry or flushed skin.
• Nausea, vomiting, or abdominal pain.
• Difficulty breathing.
• Fruity odour on breath.
• A hard time paying attention, or confusion.

Checking for ketones

It is easy to detect ketone levels with a simple urine test.

To perform a urine test, collect urine into a clean container and dip the test strip into the urine.  Urine testing strips contain special chemicals that change colours when they react with ketones.  Interpret the test results by comparing the test strip to the colour chart on the package.

Why do people test for ketones?

Ketones are only produced in the liver.  Ketones in the urine are caused by an abnormal carbohydrate metabolism.  When there are ketones present in the urine, it’s called ketonuria.

Frequently, ketonuria is a sign of diabetic ketosis.  Ketonuria may also be noted in case of insulin overdoses, starvation (e.g., slimming diet, low carb diet), dangerous metabolic abnormalities during pregnancy (hyperemesis gravidarum), acetonemic vomiting of infants and fever caused especially by infections.