Table of ContentsView AllTable of ContentsMeter OptionsTest StripsHow to TestFor DiabetesFor Ketogenic DietFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Meter Options
Test Strips
How to Test
For Diabetes
For Ketogenic Diet
Frequently Asked Questions
Everyone has ketones, and they’re normally not a health concern. But if you havediabetes, high ketone levels can causediabetic ketoacidosis (DKA), a potentially life-threatening complication.
Monitoring your ketone levels with a blood ketone meter may be recommended, especially if you havetype 1 diabetes. Ketone testing is particularly importantduring periods of illness.
You might also use a blood ketone meter if you’re following aketogenic dietand want to ensure you’re inketosis.
This article discusses the purpose of blood ketone testing and the different blood ketone meters available. It also explains the use of blood ketone test strips and tips for buying them.
Blood Ketone Meters for Testing at Home
To test the ketones in your blood, you will need a blood ketone meter and a kit that includes the lancet pen and ketone test strips. These meters also read blood glucose test strips. Results download to your computer.
Other brands and models may be available, including but not limited to:
Ketone Test Strips
You must purchase ketone test strips as glucose test strips won’t test for ketones. You will also need to use blood from your fingertip rather from an alternate site.
Ketone Levels: Where Should I Be and How Can I Check?
How to Test Your Blood for Ketones
How to Read Your Blood Ketone Test Results
Ketone Testing in Diabetes
People withdiabetestest for ketones to look for signs of diabetic ketoacidosis. If you have diabetes, you should test for ketones when:
Studies have found that blood ketone monitoring is effective in decreasing emergency room visits and hospitalizations. It also improves the time to recovery in people who develop diabetic ketoacidosis.
Blood Ketone Results for People With Diabetes
Learn how to read your blood ketone results and discuss with your healthcare provider at what level you need to call her, which will depend on individual factors. These are general guidelines:
Ketone Testing for Ketogenic Diets
If you have normal blood glucose, your blood ketones may be the highest in the morning after your overnight fast. However, many people report that their ketones rise over the course of the day. If you want to track your blood ketones day-to-day, picking one time of day and sticking with it will give you the best comparison.
Some factors besides the overall diet which may cause fluctuations include exercise and consuming fats with medium-chain triglycerides, such as coconut oil or MCT oil. And, of course, eating something (usually high in carbs) that knocks you out of ketosis will cause your ketone level to plummet.
How to Interpret the Results for Ketogenic Diets
If you are new to ketogenic diets and have a goal of nutritional ketosis (often defined as between 0.5 and 3 mmol/L), know that it can take two to four weeks to get consistently into this range.It often takes a fair amount of tweaking to figure out what you can and can’t eat, even for people who are low-carb veterans.
While uncommon, it is possible to have non-diabetic ketoacidosis (NDKA). This is a life threatening condition which requires immediate medical care.
People most at risk for NDKA are:
Ketoacidosis vs. KetosisKetoacidosisoccurs when blood sugar and ketone levels are high. This increases the acidity of the blood and is a medical emergency.Ketosis, on the other hand, simply means you have elevated ketones—but not so elevated that they are dangerous. This can happen overnight or when you’re dieting.
Ketoacidosis vs. Ketosis
Ketoacidosisoccurs when blood sugar and ketone levels are high. This increases the acidity of the blood and is a medical emergency.Ketosis, on the other hand, simply means you have elevated ketones—but not so elevated that they are dangerous. This can happen overnight or when you’re dieting.
Ketoacidosisoccurs when blood sugar and ketone levels are high. This increases the acidity of the blood and is a medical emergency.
Ketosis, on the other hand, simply means you have elevated ketones—but not so elevated that they are dangerous. This can happen overnight or when you’re dieting.
A Word From Verywell
If you have diabetes, taking your blood ketone levels can lower your risk of hospitalization and complications of diabetes such as ketoacidosis. Discuss home ketone testing with your healthcare provider. If you don’t have diabetes, you may not be familiar with using fingerstick home blood testing and you will need to learn how to do it correctly.
When buying an FDA-approved ketone meter, it comes down to individual choice and which you find easiest to use. Always follow the directions scrupulously and repeat the test if you think you have made an error, as it will affect the results.
Frequently Asked QuestionsYes. In addition, research indicates that people find blood ketone meters more convenient and are more likely to test ketones with one than with urine ketone strips.Learn MoreTesting Urine for KetonesPossibly, but only if the ketone meter is medically necessary. Insurance is not likely to cover blood ketone meters for people who are testing to see if they are in dietary ketosis. However, people with diabetes who have a history of ketoacidosis may be able to make a case for coverage.Learn MoreBest Diabetic Supply CompaniesWhen using a blood ketone meter to monitor your ketone levels on the keto diet, nutritional ketosis is between 0.5 and 3 mmol/L. You are in ketosis if your ketone meter results are in that range.Yes, drinking water can help to flush ketones from your body. For people with diabetes, this can help prevent diabetic ketoacidosis (DKA). In those following a keto diet for weight loss, this may help minimize diet-related side effects, such as bad breath.It is unclear how long you can safely stay in ketosis. The studies on ketosis and a ketogenic diet are of low quality and don’t provide specific guidelines. Two studies of people with overweight or obesity indicated that being in ketosis for 8-12 weeks was safe.However, there is controversy regarding safety and health outcomes in the long term, especially for people with diabetes.One study found that 12 weeks in ketosis created deficiencies in micronutrients such as calcium.
Yes. In addition, research indicates that people find blood ketone meters more convenient and are more likely to test ketones with one than with urine ketone strips.Learn MoreTesting Urine for Ketones
Yes. In addition, research indicates that people find blood ketone meters more convenient and are more likely to test ketones with one than with urine ketone strips.
Learn MoreTesting Urine for Ketones
Possibly, but only if the ketone meter is medically necessary. Insurance is not likely to cover blood ketone meters for people who are testing to see if they are in dietary ketosis. However, people with diabetes who have a history of ketoacidosis may be able to make a case for coverage.Learn MoreBest Diabetic Supply Companies
Possibly, but only if the ketone meter is medically necessary. Insurance is not likely to cover blood ketone meters for people who are testing to see if they are in dietary ketosis. However, people with diabetes who have a history of ketoacidosis may be able to make a case for coverage.
Learn MoreBest Diabetic Supply Companies
When using a blood ketone meter to monitor your ketone levels on the keto diet, nutritional ketosis is between 0.5 and 3 mmol/L. You are in ketosis if your ketone meter results are in that range.
Yes, drinking water can help to flush ketones from your body. For people with diabetes, this can help prevent diabetic ketoacidosis (DKA). In those following a keto diet for weight loss, this may help minimize diet-related side effects, such as bad breath.
It is unclear how long you can safely stay in ketosis. The studies on ketosis and a ketogenic diet are of low quality and don’t provide specific guidelines. Two studies of people with overweight or obesity indicated that being in ketosis for 8-12 weeks was safe.However, there is controversy regarding safety and health outcomes in the long term, especially for people with diabetes.One study found that 12 weeks in ketosis created deficiencies in micronutrients such as calcium.
It is unclear how long you can safely stay in ketosis. The studies on ketosis and a ketogenic diet are of low quality and don’t provide specific guidelines. Two studies of people with overweight or obesity indicated that being in ketosis for 8-12 weeks was safe.
However, there is controversy regarding safety and health outcomes in the long term, especially for people with diabetes.One study found that 12 weeks in ketosis created deficiencies in micronutrients such as calcium.
When to Call a Provider About Ketone Readings
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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American Diabetes Association.DKA (Ketoacidosis) & Ketones.
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American Diabetes Association.Five things to know about ketones.
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Firman CH, Mellor DD, Unwin D, Brown A.Does a ketogenic diet have a place within diabetes clinical practice? Review of current evidence and controversies.Diabetes Ther. 2024;15(1):77-97. doi:10.1007/s13300-023-01492-4
Kenig S, Petelin A, Poklar Vatovec T, Mohorko N, Jenko-Pražnikar Z.Assessment of micronutrients in a 12-wk ketogenic diet in obese adults.Nutrition. 2019;67-68:110522. doi:10.1016/j.nut.2019.06.003
Klocker AA, Phelan H, Twigg SM, et al.Blood β-hydroxybutyrate vs. urine acetoacetate testing for the prevention and management of ketoacidosis in Type 1 diabetes: a systematic review.Diabet Med. 2013;30(7):818-24. doi:10.1111/dme.12136Misra S, Oliver N.Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis.Diabet Med. 2015;32(1):14-23. doi:10.1111/dme.12604Paoli, A., Rubini, A., Volek, J.et al.Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.Eur J Clin Nutr.2013;67:789–796. doi:10.1038/ejcn.2013.116
Klocker AA, Phelan H, Twigg SM, et al.Blood β-hydroxybutyrate vs. urine acetoacetate testing for the prevention and management of ketoacidosis in Type 1 diabetes: a systematic review.Diabet Med. 2013;30(7):818-24. doi:10.1111/dme.12136
Misra S, Oliver N.Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis.Diabet Med. 2015;32(1):14-23. doi:10.1111/dme.12604
Paoli, A., Rubini, A., Volek, J.et al.Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.Eur J Clin Nutr.2013;67:789–796. doi:10.1038/ejcn.2013.116
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