Making Sense of Ketones with Diabetes

In this post, we explore ketones and the dangerous related complication, ketoacidosis, a major concern for those living with Type 1 diabetes (it is rarely found in people with Type 2 diabetes).

What are Ketones?

In people with Type 1 diabetes, the body is unable to produce insulin, the hormone necessary for the cells to effectively break down blood sugar and use it for energy. Without insulin treatments, blood sugar gradually builds up in the body which can lead to dangerous complications, including cardiovascular disease, kidney disease and nerve damage.

In some instances, insulin treatments can still fall short. When this happens, not only do blood sugar levels rise, the body, due to its inability to burn sugar, now turns to burning fat for energy. The process of burning fat produces a buildup of acids in the bloodstream called ketones. Because the body senses its inadequate amount of insulin, it keeps releasing fat cells into circulation in order to use them for energy. This, of course, means the body keeps producing more and more ketones in what amounts to a vicious cycle because too many ketones in the blood can actually poison the body and lead to a dangerous condition known as diabetic ketoacidosis that requires immediate medical attention. If left untreated, ketoacidosis can result in a diabetic coma or even death.


Signs Of Diabetic Ketoacidosis (DKA)

The symptoms of ketoacidosis can develop slowly, as it takes some time for ketones to build up in the system. However, once the signs show themselves the disease and dangers can develop quite rapidly.  So, what are some indicators that you might have ketoacidosis? Symptoms include:

– Excessive Thirst

– Frequent Urination

– Extreme Fatigue

– Nausea

– Vomiting

– Abdominal Pain

– Fruity Odor on Breath

– Confusion


If you have diabetes, particularly Type 1, and experience any of these symptoms, contact your diabetes health care provider immediately or head to the emergency room of your nearest hospital. Diabetic ketoacidosis is a very dangerous condition, and you are much better off being safe than sorry.


Can I Test for Ketones?

The answer is yes. You can detect ketones with a simple and inexpensive over-the-counter urine test strip that is pretty similar to a standard blood sugar test strip. When the strip is dipped in urine, it will change color based on your ketone level. You then simply compare the color on the strip to the corresponding chart usually found on or in the packaging to determine ketone level.


When Should I Test for Ketones?

According to the American Diabetes Association, you should test for ketones any time you test your blood sugar, whether using a standard glucose meter and test strips or a continuous glucose monitoring system, and the result is greater than 240mg/dl.

The Mayo Clinic points out that you should also test for ketones anytime you experience an illness or infection – even something as mild as the common cold. Being sick can cause the body to produce higher levels of certain hormones, including adrenaline and cortisol, which unfortunately can lead to higher insulin resistance, and in some instances can trigger the onset of ketoacidosis. The Mayo Clinic adds that pneumonia and urinary tract infections are common illnesses that can lead to ketoacidosis.

Additionally, you should test for ketones if you’ve had an issue with your insulin therapy. Perhaps you missed a scheduled treatment, or maybe your insulin pump malfunctioned. The point is not getting your prescribed insulin dosage for whatever reason can leave you a lot more susceptible to ketoacidosis.


Is it Possible to Lower my Ketones?

If you test and measure small ketone increases and are not experiencing telltale symptoms that might indicate ketoacidosis, you can try to flush out the excess ketones by drinking added fluids. Consume 8 ounces of water every 30-60 minutes and test your blood sugar every 3-4 hours to see if it goes down. Remember elevated ketones are associated with insulin deficiency and increases in blood sugar. If your blood sugar goes down after a few hours, your ketones will likely follow suit. This being said, if your urine test shows moderate or high levels of ketones, contact your doctor right away or head to an urgent care facility.


How to Avoid Elevated Ketones

Like many aspects of living with diabetes, managing your risk of developing high ketone levels and avoiding diabetic ketoacidosis is to a large degree in your hands. The two primary things you can do are commit to your doctor-prescribed diabetes treatment and medication schedule and make smart choices that contribute to a healthy diabetes lifestyle. In other words, prevention is the best medicine.


  1. Make healthy eating and physical activity a part your daily routine.
  1. Take oral medications and insulin, whether by syringe or pen needle, as directed by your diabetes physician. This is critical to stabilizing your blood sugar and keeping it within your target range, which is the key to avoiding elevated ketones.
  1. Test your blood sugar regularly. For most people, doctors recommend testing three or four times a day. For others, it’s even more frequent. Regular testing is important because it allows you to spot factors that influence your blood sugar level - foods, activity, time of day, etc. Testing will help you determine things that might cause a rise in blood sugar and build a treatment plan around them, so you can lower your risk for high ketones and ketoacidosis.
  1. Track your blood sugar levels. It’s important to log your test results to spot any clear patterns in elevated and low blood sugar. Today most glucose meters can store hundreds of readings, making it easy to share data with your physician and care team. 
  1. Test for ketones when you’re ill or stressed. These are times when you’re more likely to experience elevated ketones. If levels are moderate or high, contact your doctor right away.
  1. Don’t take chances. If your blood sugar is high, you have excess ketones in your urine, and you believe it might be ketoacidosis, seek emergency care right away. This condition may require intravenous fluids, electrolyte replacement and insulin therapy that all must be administered by medical professionals. Ketoacidosis is a life-threatening condition and certainly not one to take lightly. If you suspect it, get care right away.

We hope you found this post informative and helpful. At Diabetic Warehouse, we’re committed to keeping you up to date with the latest news and tips on living with diabetes. We’re also committed to saving you up to 65% on doctor-recommended diabetic supplies from leading manufacturers, such as Accu-Chek, OneTouch, FreeStyle, Easy Comfort, Clever Choice, TRUEmetrix and many others.


Visit us online to explore our complete selection of diabetic supplies, including test stripslancetsinsulin syringespen needlesinfusion setscontinuous glucose monitoring systems (CGM) and ketone test strips. Enjoy free delivery to your home or office with every order. Hear what our satisfied customers have to say, and get started saving on all your diabetic supplies now at


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