Table of ContentsView AllTable of ContentsHigh Ketone LevelsSymptomsCausesWhen to TestComplications
Table of ContentsView All
View All
Table of Contents
High Ketone Levels
Symptoms
Causes
When to Test
Complications
However, high ketone levels in urine may be a sign of too much acid in your body (ketoacidosis). People with diabetes are at risk of a life-threatening complication known as diabetic ketoacidosis (DKA). If left untreated, DKA can cause damage to organs and even death.
This article explains the signs and symptoms of ketones in urine. It will also discuss what conditions can trigger ketonuria, possible complications, and when to seek emergency care for ketoacidosis.
What High Ketone Levels Mean
A high level of ketones in the urine is known as ketonuria, a potentially serious health concern.
Ketones are released when the body breaks down fat to use for energy. Glucose (blood sugar) is the body’s main fuel source. When glucose is unavailable, the body burns fat instead.
This happens when fasting or on a very low carbohydrate diet. Known as nutritional ketosis, it causes small to moderate levels of ketones in urine.
High ketone levels are more common in people with diabetes and can lead to DKA. It occurs when the body doesn’t have enoughinsulinto allow blood sugar into cells. Instead, the liver breaks down fat, producing acids called ketones. These can build up to dangerous levels and require prompt medical attention.
How to Test for KetonesYou can test for ketones in urine at home using over-the-counter ketone test strips. They change color based on the concentration of ketones in your urine. A slight color change shows you have a trace or small amounts of ketones, which is normal. Darker color changes indicate moderate to large amounts of ketones and are at risk of ketoacidosis.
How to Test for Ketones
You can test for ketones in urine at home using over-the-counter ketone test strips. They change color based on the concentration of ketones in your urine. A slight color change shows you have a trace or small amounts of ketones, which is normal. Darker color changes indicate moderate to large amounts of ketones and are at risk of ketoacidosis.
Symptoms of High Ketone Levels
High levels of ketone in urine tend to occur when a person has high blood sugar. Common symptoms of ketonuria include:
Ketonuria symptoms are sometimes the first sign that a person may have diabetes. If you have these symptoms, see your healthcare provider.
When Should My Ketones Be Checked?
Causes of High Ketone Levels
Ketonuria is most common in people with diabetes, particularlytype 1 diabetes. With diabetes, the body either doesn’t produce enough insulin (the hormone that regulates the production and storage of glucose) or doesn’t use insulin properly.
So, if you have high ketones in your urine, it is an indication of an insulin problem.
However, there are other reasons why you might experience ketonuria, namely if the body’s glucose stores are severely depleted. Reasons for this might include:
Severe infections, includingCOVID-19, can also lead to ketonuria.
How to Safely Try a Keto Diet With Diabetes
When Should You Get Your Ketones Tested?
People with diabetes should test their urine for ketones when blood sugar is higher than 300 mg/dL and does not come down with insulin.
People with or without known diabetes should test for ketones if they experience the following signs of ketoacidosis:
Complications Associated With High Ketones
If you haveuncontrolled diabetes, ketone levels can skyrocket. High levels can cause acids to rapidly accumulate in the blood, leading to ketoacidosis. This is damaging to your vital organs and can even lead to death if not treated appropriately.
In people with diabetes, the condition is known as diabetic ketoacidosis (DKA). In those without, it is referred to as non-diabetic ketoacidosis (non-DKA).
Complications of ketoacidosis include:
When to Call 911Call 911 or rush to your nearest emergency if you have diabetes and experience the following:Blood sugar readings that remain at or above 300 mg/dLHigh ketone levelsVomitingTrouble breathingOther signs and symptoms of DKA
When to Call 911
Call 911 or rush to your nearest emergency if you have diabetes and experience the following:Blood sugar readings that remain at or above 300 mg/dLHigh ketone levelsVomitingTrouble breathingOther signs and symptoms of DKA
Call 911 or rush to your nearest emergency if you have diabetes and experience the following:
Urine Ketone Test: Purpose, How to Buy, Strip Results
Summary
Ketonuria is a possible complication of diabetes, particularly type 1 diabetes, but can also occur with long-term vomiting or diarrhea, pregnancy, eating disorders, and infections. Symptoms include frequent urination, fruity breath, extreme fatigue, nausea or vomiting, and breathing difficulty.
How to Use a Blood Ketone Meter
8 SourcesVerywell 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.MedlinePlus.Ketones in urine.Gershuni VM, Yan SL, Medici V.Nutritional ketosis for weight management and reversal of metabolic syndrome.Curr Nutr Rep. 2018;7(3):97-106. doi:10.1007/s13668-018-0235-0Centers for Disease Control and Prevention.Diabetic ketoacidosis.American Diabetes Association.Five things to know about ketones.Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A.COVID-19 infection may cause ketosis and ketoacidosis.Diabetes Obes Metab. 2020;22(10):1935-1941. doi:10.1111/dom.14057Luethi N, Cioccari L, Crisman M, Bellomo R, Eastwood GM, Mårtensson J.Prevalence of ketosis, ketonuria, and ketoacidosis during liberal glycemic control in critically ill patients with diabetes: an observational study.Crit Care. 2016;20:297. doi:10.1186/s13054-016-1462-7MedlinePlus.Acidosis.MedlinePlus.Diabetic ketoacidosis.
8 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.MedlinePlus.Ketones in urine.Gershuni VM, Yan SL, Medici V.Nutritional ketosis for weight management and reversal of metabolic syndrome.Curr Nutr Rep. 2018;7(3):97-106. doi:10.1007/s13668-018-0235-0Centers for Disease Control and Prevention.Diabetic ketoacidosis.American Diabetes Association.Five things to know about ketones.Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A.COVID-19 infection may cause ketosis and ketoacidosis.Diabetes Obes Metab. 2020;22(10):1935-1941. doi:10.1111/dom.14057Luethi N, Cioccari L, Crisman M, Bellomo R, Eastwood GM, Mårtensson J.Prevalence of ketosis, ketonuria, and ketoacidosis during liberal glycemic control in critically ill patients with diabetes: an observational study.Crit Care. 2016;20:297. doi:10.1186/s13054-016-1462-7MedlinePlus.Acidosis.MedlinePlus.Diabetic ketoacidosis.
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.
MedlinePlus.Ketones in urine.Gershuni VM, Yan SL, Medici V.Nutritional ketosis for weight management and reversal of metabolic syndrome.Curr Nutr Rep. 2018;7(3):97-106. doi:10.1007/s13668-018-0235-0Centers for Disease Control and Prevention.Diabetic ketoacidosis.American Diabetes Association.Five things to know about ketones.Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A.COVID-19 infection may cause ketosis and ketoacidosis.Diabetes Obes Metab. 2020;22(10):1935-1941. doi:10.1111/dom.14057Luethi N, Cioccari L, Crisman M, Bellomo R, Eastwood GM, Mårtensson J.Prevalence of ketosis, ketonuria, and ketoacidosis during liberal glycemic control in critically ill patients with diabetes: an observational study.Crit Care. 2016;20:297. doi:10.1186/s13054-016-1462-7MedlinePlus.Acidosis.MedlinePlus.Diabetic ketoacidosis.
MedlinePlus.Ketones in urine.
Gershuni VM, Yan SL, Medici V.Nutritional ketosis for weight management and reversal of metabolic syndrome.Curr Nutr Rep. 2018;7(3):97-106. doi:10.1007/s13668-018-0235-0
Centers for Disease Control and Prevention.Diabetic ketoacidosis.
American Diabetes Association.Five things to know about ketones.
Li J, Wang X, Chen J, Zuo X, Zhang H, Deng A.COVID-19 infection may cause ketosis and ketoacidosis.Diabetes Obes Metab. 2020;22(10):1935-1941. doi:10.1111/dom.14057
Luethi N, Cioccari L, Crisman M, Bellomo R, Eastwood GM, Mårtensson J.Prevalence of ketosis, ketonuria, and ketoacidosis during liberal glycemic control in critically ill patients with diabetes: an observational study.Crit Care. 2016;20:297. doi:10.1186/s13054-016-1462-7
MedlinePlus.Acidosis.
MedlinePlus.Diabetic ketoacidosis.
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