How do you know you have ketones in your urine?

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Definition

A ketone urine test measures the amount of ketones in the urine.

Alternative Names

Ketone bodies - urine; Urine ketones; Ketoacidosis - urine ketones test; Diabetic ketoacidosis - urine ketones test

How the Test is Performed

Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly.

How to Prepare for the Test

You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Ketone testing is most often done if you have type 1 diabetes and:

Your blood sugar is higher than 240 milligrams per deciliter (mg/dL)

Nausea or vomiting occur

Pain in the abdomen

Ketone testing may also be done if:

You have an illness such as pneumonia, heart attack, or stroke

Nausea or vomiting that does not go away

You are pregnant

Normal Results

A negative test result is normal.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

An abnormal result means you have ketones in your urine. The results are usually listed as small, moderate, or large as follows:

Small: <20 mg/dL

Moderate: 30 to 40 mg/dL

Large: >80 mg/dL

Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. This may be due to diabetic ketoacidosis (DKA) . DKA is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.

An abnormal result may also be due to:

Fasting or starvation: such as with anorexia (an eating disorder)

(an eating disorder) High protein or low carbohydrate diet

Vomiting over a long period (such as during early pregnancy)

Acute or severe illnesses, such as sepsis or burns

High fevers

The thyroid gland making too much thyroid hormone ( hyperthyroidism )

) Nursing a baby, if the mother does not eat and drink enough

Risks

There are no risks with this test.

References

Chernecky CC, Berger BJ. Ketone, semiquantitative - urine. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:694. Sacks DB. Diabetes mellitus. In: Tifai N, ed. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 57.

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What is silent diabetes?

“Diabetes starts as a silent disease, advancing painlessly, almost imperceptibly,” says Dr. Ferrer, who sees 25 to 30 diabetic patients per week. “It mainly attacks the small blood vessels, damaging the kidneys, eyes, and nerves.” It can also affect larger blood vessels.

kelsey-seybold.com - Diabetes: Beware this 'Silent Disease' - Kelsey-Seybold Clinic

Be on the lookout for signs and symptoms

“Characterized by high levels of sugar in the blood, diabetes is a dangerous and destructive disease,” says Dennis Ferrer, MD, a board-certified physician specializing in Endocrinology at Kelsey-Seybold Clinic. “Diabetes starts as a silent disease, advancing painlessly, almost imperceptibly,” says Dr. Ferrer, who sees 25 to 30 diabetic patients per week. “It mainly attacks the small blood vessels, damaging the kidneys, eyes, and nerves.” It can also affect larger blood vessels. “Patients often don’t realize that coronary artery disease is associated with high levels of blood sugar,” Dr. Ferrer says. “Diabetes and its associated conditions can cause coronary arteries to become inflamed, narrowed, or obstructed, thus setting the stage for a heart attack or stroke.” Type 1 diabetes most often is diagnosed in childhood and young adulthood. It’s characterized by the inability of the pancreas to produce insulin. Although not curable, it can be managed with insulin injections and diet. During Type 2 diabetes, typically occurring at a more mature age, the pancreas is initially able to produce insulin, but the body’s cells don’t use the glucose properly, causing metabolic problems, including blackouts. Type 2 diabetes is usually preventable. Obesity, for example, increases the risk. But heredity may also be a contributing factor. Symptoms of Type 2 diabetes include chronic fatigue, excessive thirst, and frequent, sleep-interrupting incidents of nighttime urination. “The good news is that Type 2 diabetes is sometimes managed through lifestyle changes without medication,” Dr. Ferrer adds. “If you feel you’re at risk, get examined by a qualified physician. And do it soon.”

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