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Ketone 1 in urine: Ketones in Urine: MedlinePlus Medical Test

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Ketones in Urine Test: What It Measures and What Results Mean

A test to detect ketones in urine can be administered at home or in a lab. Sometimes patients are asked not to eat or drink for a specified amount of time before they take the test.

When testing in a lab, patients are advised to wash their hands and then clean their genital area via a sterile cleansing pad. Patients must then collect 1 to 2 ounces of urine into a container, and give the sample to the appropriate healthcare provider. (1)

Patients can also test for ketones in urine at home by doing a spot test, which uses urine test strips. You can capture the urine in a clean container and dip the test strip into the container, or you can urinate directly onto the test strip. Follow the instructions to see how long after testing you should read the color of the strip. Then compare the strip color with the color chart on the bottle. (5)

If you are testing for ketones in babies or toddlers who wear diapers, clean cotton wool can also be used to capture urine. (5)

When testing your urine for ketones, it’s important to make sure that the test strips have not expired.

You do not need a prescription to obtain a ketone test kit from your local pharmacy. Talk to your doctor about which test kit could work best for you and provide the most relevant information.

Results of the ketones in urine test can vary from a specific number or be categorized qualitatively as a small, moderate, or large amount of ketones. What’s considered a normal amount of ketones in urine will vary by age, gender, health history, and other factors, so be sure to talk to your doctor about your exercise and diet habits, as well as other factors that might affect your typical level. (1)

When Should I Have a Test for Ketones in Urine?

If you have diabetes or another condition that puts you at risk for high levels of ketones, a healthcare provider will generally advise you to test for ketones every 4 to 6 hours when you experience any of the following: (6)

  • Blood glucose level above 240 milligrams per deciliter (mg/dl)
  • Vomiting or feelings of nausea
  • Abdominal pain
  • Other illness, such as cold or flu
  • Constant fatigue
  • Dry mouth or constant thirst
  • Flushed skin
  • Fruity-smelling breath
  • Confusion

If your child has diabetes and becomes sick, he or she will need extra attention and consultation with doctors. Notify the child’s diabetes team immediately if she has a fever, vomiting, or diarrhea. Also contact a doctor if your child’s urine tests positive for ketones. (5)

What Does an Abnormal Result for a Ketones in Urine Test Mean?

Abnormal results typically break down as follows: (4)

  • Small: 20 mg/dl
  • Moderate: 30 to 40 mg/dl
  • Large: >80 mg/d

Small amounts of ketones in the urine can be normal, especially if a person is trying to lose weight and maintains healthy blood sugar levels. People with diabetes who are trying to lose weight should make sure they monitor their blood sugar and ketone levels closely. (2)

If you test for ketones in your urine and the results indicate a small amount, consult with your doctor and continue retesting every few hours. (6)

If test results show moderate or large amounts of ketones in urine, contact your healthcare provider immediately. It’s also important not to exercise when ketone levels are high or when your blood sugar is high, as this can worsen effects. (6)

If test results show high levels of ketones in your urine, your doctor may check the amount of ketones in your blood and also conduct the following urine tests: (7)

  • Blood glucose
  • Protein
  • pH (or acid level)

When Can Ketones in Urine Be a Sign of Ketoacidosis?

High levels of ketones detected in your urine are a potential indicator of diabetic ketoacidosis (DKA), a severe complication of diabetes. Diabetic ketoacidosis is often the first sign that a person has diabetes before they are diagnosed. (2)

If you become ill and have diabetes, your blood sugar and ketone levels can rise and cause ketoacidosis. Consult with your healthcare provider about how to monitor your ketone and blood glucose levels and how to prevent ketoacidosis when you’re sick. (2)

Additional symptoms of ketoacidosis can include: (1)

  • Trouble breathing
  • Nausea
  • Vomiting
  • Unusual thirst
  • Fruity-smelling breath
  • Flushed skin
  • Abdominal pain
  • Confusion
  • Sleepiness
  • Unconsciousness

It’s important to seek help for DKA immediately, as it can lead to a diabetic coma or even death. (3)

Ketones in Urine: Signs, Symptoms, and Complications

It’s normal to have a small number of ketones in your body, but when ketone levels are high, it may signal serious illness or death.

Normally, your body burns sugar for energy, but there are times—namely during times of prolonged fasting and uncontrolled diabetes—when the body may need to rely on other sources like fat for energy. When the body does not have enough sugar or can’t break it down, it turns to fat which produces substances called ketones.

These ketones are important because the brain can only use glucose and ketones as an energy source. However, when ketone levels are too high, they can become toxic to the body and may instead end up in your blood and urine. 

High levels of ketones in the urine are 1.6 to 3.0 mmol/L, and very high levels are greater than 3.0 mmol/L.

georgeclerk / Getty Images

Frequent Symptoms

There are a number of reasons why ketone levels in the urine may be high, but symptoms of ketonuria more commonly develop in people with diabetes because they don’t make enough insulin or their body doesn’t respond well to insulin.

People with diabetes can’t use the sugar in the blood for energy, so they may need to test their urine for ketones more frequently so that they can monitor their condition and avoid developing symptoms altogether. 

Symptoms of ketonuria, or ketones in the urine, are only experienced when ketone levels are high, particularly above 0.6 mmol/L.

Symptoms of ketonuria include:

  • Frequent urination
  • Increased thirst
  • Muscle aches
  • Fatigue
  • Unexpected weight loss 
  • Shortness of breath or trouble breathing
  • Nausea, vomiting, or abdominal pain
  • Confusion
  • Fruity-smelling breath

If you have any of these symptoms and there is suspicion of diabetes or another condition that throws off your metabolic profile, a healthcare professional may suggest checking your ketones immediately.

The following conditions increase your risk of ketonuria:

  • Poorly controlled diabetes or a blood sugar level above 300 mg/dL
  • History of alcohol abuse
  • Pregnancy
  • Infection
  • Prolonged fasting
  • Ethanol ingestion

Rare Symptoms

There are three ketone bodies—acetoacetic acid, beta-hydroxybutyric acid, and acetone—which are usually insignificant in the blood and urine of individuals after eating or in the overnight-fasted state.

These ketones are important reserve energy sources, but if your diabetes is poorly controlled or you are in the midst of prolonged fasting or restrictive dieting, these trace levels can skyrocket to as high as 10 to 40 mmol/L, 70 times the normal amount of ketones that should be in the blood or urine.

High ketone levels are toxic to the body because they acidify the blood, which needs to have a tightly regulated pH level to support proper organ function. This is especially important in those with diabetes who are at risk of developing diabetic ketoacidosis, a potentially life-threatening condition.

Other rare symptoms of ketoacidosis associated with ketonuria include:

  • Cerebral edema
  • Cardiac arrest 
  • Kidney failure
  • Coma
  • Death

Subgroups

Even if you do not have diabetes, you can develop symptomatic ketonuria. This can happen with:

  • Chronic vomiting
  • Extreme exercise
  • Extremely low-carbohydrate diets
  • Eating disorders
  • Alcohol use disorder
  • Pregnancy

Alcoholics, extreme exercisers and dieters, and pregnant women are all at high risk of developing symptomatic ketonuria.

When to See a Healthcare Professional 

If you have diabetes and are experiencing early signs of ketonuria—like fatigue or increased thirst—you may want to contact a healthcare professional. Your provider may order a urine test to check for ketones.

In the meantime, you should increase your water intake and check your blood sugar to make sure your blood sugar levels are under control. 

Whether or not you have diabetes, if you have a fruity smell on your breath, feel confused or disoriented, or have shortness of breath, you may have high ketone levels in your blood that are putting you in danger. To prevent potentially fatal complications, seek immediate medical attention. 

A Word From Verywell

If you have diabetes, you are at higher risk of developing high levels of ketones in the urine. If you have high blood sugar levels and type 1 or type 2 diabetes, it’s important to check your ketone levels to avoid serious health complications. 

Even if you do not have diabetes, you can develop symptomatic ketonuria. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders, underscoring the importance of living a healthy lifestyle and taking a holistic approach to the treatment and management of ketonuria symptoms.

Five Things to Know About Ketones

If you live with diabetes, you have probably heard that ketones are something to watch out for. That they have something to do with the dreaded diabetic ketoacidosis (DKA). But do you really understand what ketones are and why they happen?

It’s scary to think about, sure. But it’s also very important to be in the know about ketones and to be prepared.

1) What are ketones?

If there isn’t enough insulin in your system, you can’t turn glucose into energy. So your body starts breaking down body fat. Ketones are a chemical by-product of this process.

This can occur when people with type 1 diabetes don’t take insulin for long periods of time, when insulin pumps fail to deliver insulin and the wearer does not monitor blood sugar, or during serious illness (in type 1 or type 2) when insulin doses are missed or not increased appropriately for the stress of illness.

Ketones can happen to anyone with diabetes, but the condition is more common in people with type 1.

2) Why are ketones dangerous?

Ketones upset the chemical balance of your blood and, if left untreated, can poison the body. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Eventually they build up in the blood.

The presence of ketones could be a sign that you are experiencing, or will soon develop, diabetic ketoacidosis (DKA)—a life-threatening medical emergency.

3) When should I test for ketones, and how?

There are several situations in which it is a good idea to check for ketones, usually every four to six hours. Talk to your doctor to know what makes the most sense for you and your diabetes management plan.

  • Your blood sugar is more than 300 mg/dl (or a level recommended by your doctor)
  • You feel nauseated, are vomiting or have abdominal pain
  • You are sick (for example, with a cold or flu)
  • You feel tired all the time
  • You are thirsty or have a very dry mouth
  • Your skin is flushed
  • You have a hard time breathing
  • Your breath smells “fruity”
  • You feel confused or “in a fog”

Ketone test strips are available at your pharmacy. They kits are quick and simple to use—though it is important to follow the instructions closely. Always have test strips on hand and check their expiration date.

Make sure you understand the directions in advance, and ask your doctor or nurse if you would like a demonstration. Generally, the test will involve dipping a strip in a urine sample, waiting for it to change color, then comparing your results to a chart on the packaging. The color will estimate the concentration of ketones in your urine. Remember to record your results!

4) When should I call my doctor for this?

Talk to your doctor immediately if your urine results show moderate or large amounts of ketones. This is a sign that your diabetes is out of control, or that you are getting sick. If you are unable to reach your diabetes care team, head for the emergency room or an urgent care facility.

Share the notes from your log, as this important data will provide clues as to how to treat you and adjust your diabetes management plan.

Small or trace amounts of ketones may mean that ketone buildup is starting. You should increase your intake of fluids (water is best) and take other steps to get your blood sugar levels in check. You should test again in a few hours. Call your doctor if the levels increase.

5) Will exercise help?

Exercise is often a good way to bring down high blood sugar—but not when ketones are present. Never exercise when your urine checks show moderate or large amounts of ketones and your blood sugar is high. It may make your blood sugar level go even higher.

Learn more about ketones

What are ketones, and why are they dangerous?

Ketosis, or the process of burning ketones, has become a familiar buzzword—thanks to the popular low-carb ketogenic diet. Before this fad diet exploded across the U.S., ketones were really only known to healthcare professionals and those with diabetes—and were not necessarily a good thing. Here, learn what ketones are, and how they can be dangerous.

What are ketones?

“Ketones are water-soluble molecules that are produced by the liver. They are formed from fatty acids within the body when your body doesn’t produce enough insulin to convert glucose into energy,” says David Nazarian, MD, of My Concierge MD in Beverly Hills. 

Simply put, ketones (or ketone bodies) are an alternative fuel that is made in your liver when there is not enough glucose (sugar) for energy. When your body doesn’t have enough sugar or glucose for energy, your body needs a new energy source. Your body will then switch to breaking down fat for energy. This process is done in the liver, where fats are turned into a chemical called ketones. The ketones, a fatty acid, are then released from the liver and go into your bloodstream and are used as fuel to drive the body’s metabolism and to support muscle function. 

The body typically needs ketones when insulin levels are low. Examples of times when your body produces this alternative energy source include fasting, eating low-carb diets, or overnight when sleeping. 

In uncontrolled type 1 diabetes, ketones may be produced due to lack of insulin-producing beta cells of the pancreas or a lack of an exogenous, or outside, insulin source.

Measuring ketone production can be done with urine testing. The safe amount of ketones in urine varies from person to person and depends on their underlying health conditions. While some people can have ketones in their urine and it is normal, others should be concerned if there is a ketone build-up as this could be indicative of a more serious problem.

What is the most accurate way to measure ketones?

A blood meter or at-home urine test kit can are helpful in assessing ketones. The urine kit typically comes with a cup and test strips that you dip into the urine. The most accurate way to measure ketones, the gold standard in healthcare, is through a blood ketone meter (note: a glucose meter does not measure the same thing).

How often should you check ketones?

People newly diagnosed with diabetes should check their levels twice daily when they are first diagnosed. For those without diabetes, who want to measure ketones for weight-loss reasons, 0.5 mmol/L in blood or urine means you’ve achieved ketosis. 

Are ketones dangerous?

For those without diabetes, it’s not typically an issue when your body produces ketones. However, for people with diabetes, ketones can be very dangerous. This is because the body can’t regulate insulin, glucagon, and other hormones in those with diabetes. 

“High levels of ketones can be dangerous and can cause health issues. Dangerously high levels of ketones in our bodies usually occur in insulin-dependent diabetic type one patients who do not take their insulin,” said Dr. Nazarian, “It can lead to dehydration and can also change the chemical balance of your blood. Your blood becomes more acidic which if not corrected can lead to a coma or death.”

This chart explains healthy and dangerous ranges of ketones: 

Negative ketones Less than 0.6 millimoles per liter (mmol/L)
Low to moderate 0.6 to 1.5 mmol/L
High 1.6 to 3.0 mmol/L
Very high greater than 3.0 mmol/L

If your levels are low-moderate, call your doctor to discuss these levels to receive further testing. At your visit, your doctor will likely perform a urine or blood test to determine ketone levels and perform a blood sugar test. For levels greater than 1.6 it is important to seek emergency attention as symptoms could be life-threatening. 

Symptoms of high ketones

Symptoms associated with high ketone levels typically include:

  • Unquenchable thirst
  • Frequent urination
  • Dry mouth (xerostomia)
  • High blood sugar levels (over 240)

Untreated symptoms could progress to additional and more serious symptoms including:

  • Confusion or difficulty focusing
  • Fatigue
  • Nausea
  • Vomiting
  • Dry or flushed skin
  • Difficulty breathing
  • Breath characterized by a fruity smell
  • Abdominal pain

Diabetic ketoacidosis (DKA) is a serious complication of diabetes and can be a result of unaddressed ketone levels. This will cause blood to become acidic. This is a serious and life-threatening issue that can lead to brain swelling, diabetic coma or death. 

What if my ketones are too high?

If your levels are too high based on ketone testing, it is important to seek emergency medical treatment. You will likely have the symptoms listed above and it is possible it could lead to DKA. 

A medical professional will treat this condition within a hospital. Some common ways to treat are: 

  • IV fluids to help the patient from becoming dehydrated due to frequent urination
  • Electrolyte replacement to help boost the lost electrolytes. 
  • Insulin helps the body convert back to running on glucose instead of ketones for energy. 

Diabetes management is the best way to prevent high levels, which can be done by:

  • Checking blood glucose levels regularly
  • Eating a healthy diet
  • Checking for ketones if blood sugar is above 240 mg/dl
  • Managing correct insulin dosages

While people without diabetes can have ketones in the urine, DKA is only an issue for those with diabetes. 

What Are Ketones in Urine?

What are ketones? How do they get into your urine, and why should you care?

Ketones are everywhere in nature and in our bodies. We couldn’t live without them. Proteins and fats are largely made of them.

Our bodies normally run on glucose we get from food. When bodies don’t have glucose because of starvation or illness or can’t use glucose because of a lack of insulin, they start burning fat for energy. The fat breaks down into ketones, with these ketones pouring into the blood and some passing into the urine. This release of ketones into the urine is called “ketonuria” (pronounced KEY-tone-ER-ee-uh).

The buildup of ketones in the body is called “ketosis” (key-TOE-sis.) If your glucose is close to normal and you are well-hydrated, ketosis is no problem. Many low-carb diets create ketosis on purpose, as it can be an indicator of fat burning and weight loss.

However, ketones are acids. If you have too many ketones, they can make your blood too acidic. This can lead to a very dangerous and often life-threatening situation called diabetic ketoacidosis (DKA).

Remember, ketones appear in blood and urine because the body is breaking down fats for energy. It should only happen if glucose is low. If you have above-normal glucose and also have ketones in the urine, something is seriously wrong.

Symptoms of ketoacidosis

Most of the classic symptoms of diabetes are symptoms of ketoacidosis:

• Excessive thirst
• Dry mouth
• Frequent urination
• Fruity-smelling breath (ketones have a fruity smell)

Later, more dangerous symptoms include:

• Nausea and vomiting
• Abdominal pain
• Confusion
• Weakness and fatigue
• Shortness of breath

What causes ketonuria in diabetes?

In people with Type 1, ketonuria means they’re not getting enough insulin. Insulin keeps fat from breaking down, so ketones should not form if you’re taking enough insulin.

People with Type 2 can develop ketonuria if they have severe infections, major trauma, or stress. These conditions raise the need for insulin. People can have internal infections without being aware of them.

A study in Chicago evaluated 138 consecutive admissions for DKA at a large academic center. They found that 21.7 percent of those admitted had Type 2 diabetes. Almost half of the people admitted had an identifiable infection. In a Swedish study, 32 percent of DKA cases were people with Type 2.

A subset of people with Type 2 have what is called ketosis-prone diabetes or KPD. In KPD, the pancreas occasionally shuts down insulin production for unknown reasons, making a person subject to DKA.

In Type 1, a common cause of ketonuria is insulin pump failure. A person thinks they are getting insulin, but they’re not. The line has been blocked or the machine is malfunctioning. Without insulin, fat starts breaking down into ketones.

The University of California at San Francisco diabetes education program warns, “There is a higher risk for developing ketones on pump therapy. This is because long-acting insulins are not used, and rapid-acting insulin is delivered in extremely small amounts. If this basal insulin delivery is interrupted for more than an hour, check your blood sugar and ketones.”

Sickness raises the risk of DKA in all people with diabetes, but especially Type 1. Illness often tends to raise the need for insulin but frequently decreases a person’s appetite, resulting in less food intake than usual. Because they’re eating less, some people may decrease their insulin dosages, when they really may need increased amounts of insulin.

When to check urine for ketones

Urine ketone test strips are quite cheap, and you should always have some available. (The Nova Max Plus meter can test the blood for ketones.) Test whenever:

• There is an unexplained rise in your blood sugar, or you have a blood sugar level of more than 250 mg/dl (13.9 mmol/l) for two tests in a row;

• You have symptoms of nausea, vomiting, confusion, or severe fatigue;

• You have any symptoms of ketoacidosis such as increased thirst and urination, stomachache, or dry mouth;

• If you have a flu, infection, or injury;

• When you’re planning to exercise, but your blood sugar is over 250 mg/dl.

• If you are pregnant, check for ketones each morning before breakfast or whenever your glucose goes over 250 mg/dl.

Managing ketones

If you have ketones in your urine (or blood):

• Have a sick-day care plan worked out with your doctor. Keep in touch with your health-care providers if you have ketonuria and high glucose. You may need to be checked for an underlying cause or may require additional insulin to bring blood glucose levels down.

• Call your doctor if you’re vomiting. Vomiting can speed up DKA.

• Drink plenty of water (or other calorie-free fluids) to flush the ketones out of your body.

• Monitor blood sugar levels and ketones every three to four hours.

• Avoid exercising when you have ketones and your blood glucose is above 250 mg/dl. This is because when you do not have sufficient insulin, the increased energy demands of exercise will burn fat, producing additional ketones.

• If you are using an insulin pump and have ketones, inject some insulin as needed depending on your blood glucose level and change the pump infusion set and reservoir.

Want to learn more about ketones and diabetes? Read “Ketones: Clearing Up the Confusion” and “Getting to Know Ketones,” then try your hand at the quiz “How Much Do You Know About Ketones?”

Urine tests, blood tests, and ketoacidosis

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A ketone is an organic compound that the body produces when it breaks down fat for energy. This process is known as ketosis.

Ketone testing is an essential part of managing diabetes. This is because diabetes makes it difficult for the body to regulate its levels of ketones. High ketone levels can be dangerous.

If a person has too many ketones in their blood, they may be at risk of developing diabetic ketoacidosis (DKA). DKA causes the blood to become too acidic, and the person may lose consciousness.

It is important to spot the signs of high ketones before this happens, as DKA is a medical emergency.

People can test their ketone levels using blood tests and urine tests. They can also look out for the symptoms of high ketone levels, which include thirst, nausea, confusion, and fruity-smelling breath.

In this article, we explain when to check for ketones, the types of tests available, and how to understand the results.

Ketones are a class of organic compound that the body produces when it burns fat for energy.

The blood always contains three types of ketones:

  • acetoacetate (AcAc)
  • 3-β-hydroxybutyrate (3HB)
  • acetone

The body uses a range of nutrients for energy, including carbohydrates, fats, and proteins. It will use carbohydrates first, but if none are available, the body will burn fat.

As the body breaks down fats, it produces ketones. This is known as a state of ketosis. Ketosis does not cause the blood to become acidic.

Find out the differences between ketosis and ketoacidosis here.

Ketones have gained attention in recent years due to the popularity of ketogenic diets. People following a ketogenic diet consume low amounts of carbohydrates so that their body will burn fat instead of carbohydrates.

Although some individuals have experienced short-term weight loss while following the keto diet, researchers need to carry out more studies into its long-term effects.

Some experts believe that following a ketogenic diet can help with type 2 diabetes, though not everyone agrees.

Read this article to find out whether a ketogenic diet can help type 2 diabetes.

When a person eats food, insulin transports the sugar to the cells to use for energy.

When a person has diabetes, their body does not produce enough insulin to transport the blood sugar, or the cells in their body may not accept it properly. This can stop the body from using the blood sugar for energy.

When the cells cannot use sugar for energy, the body will start to break down fats for energy instead. This results in an increased level of ketones in the blood.

For those with diabetes, ketone levels can build up, leading to DKA. This is when ketone levels build up, making a person’s blood pH too low or acidic.

DKA can cause someone to lose consciousness. This is known as a diabetic coma, and it is a medical emergency.

People with type 1 diabetes have the highest risk of developing DKA, but people with type 2 diabetes can develop it as well.

Testing ketone levels is an essential part of diabetes care, and checking ketone levels in the blood can help a person manage the condition and prevent DKA.

If a person experiences any of the following signs, they may have high ketone levels and should check them:

A doctor will usually advise individuals as to when and how often they should test for ketones.

The American Diabetes Association recommend that a person checks their ketone levels every 4–6 hours if their blood sugar reaches over 240 milligrams per deciliter (mg/dl).

They also recommend that people who are ill check every 4–6 hours. This includes having a cold, flu, or an infection, as illness can increase the risk of DKA.

If the person has only recently received a diagnosis for diabetes and has started taking insulin, a doctor may advise testing twice daily to make sure they are receiving the correct amount of insulin.

Two common ways to test ketone levels are urine tests and blood tests.

A ketone urine test is simple to do, and at-home testing kits are available from drugstores or online.

Ketone urine tests are available to purchase here.

A urine testing kit will include a set of strips, sometimes foil wrapped. To use the test, a person should check that the test is not out of date and follow the instructions on the packaging.

Urine testing kits will usually include a color-coded strip that a person needs to dip in the urine. It will change color to indicate high levels of ketone, glucose, or protein.

Some blood glucose meters can also test ketone levels. To do a blood test using a blood glucose meter, a person should:

  • put a blood ketone strip into the blood glucose meter
  • prick their finger using the needle provided
  • press their finger to strip to transfer a small drop of blood
  • wait for the result to show on the meter

The amount of ketone in the blood can be either low/normal, medium/moderate, or high/large.

When a person has medium or high levels of ketones in their blood, doctors refer to it as ketonemia. It is a sign that a person’s diabetes may not be under control. Having high levels of ketones is also a risk factor for DKA.

If a person’s results are persistently moderate or high, a doctor may need to adjust their medication, or they may need to make some lifestyle changes.

There are three key reasons why a person would have moderate or high levels of ketones in their blood:

  • Lack of insulin in the blood: Someone with diabetes may need to adjust the amount of insulin they take.
  • Low blood sugar: Also known as hypoglycemia, this most often occurs in the morning when insulin levels drop.
  • Not having eaten enough food: It is essential for someone with diabetes to eat regularly, so as not to let blood sugar levels drop.

If a person’s ketone levels are moderate after more than one test, or if ketone levels are high, they should consult a doctor promptly. If they have elevated ketone levels alongside any symptoms of DKA, they should seek urgent medical attention.

The body produces ketones when there is not enough insulin in the blood. Although the body usually manages these levels naturally, it is often not possible for someone with diabetes.

Regular testing is easy to do at home and should be a standard part of managing diabetes. Trying to keep blood sugar at a healthy level and being aware of the symptoms and risk factors of DKA should help keep ketone levels within an acceptable range.

Diabetes and Ketones

The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis

Ketones build up when there is insufficient insulin to help fuel the body’s cells.

High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes.

If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible.

What are ketones?

Ketones are an acid remaining when the body burns its own fat.

When the body has insufficient insulin, it cannot get glucose from the blood into the body’s cells to use as energy and will instead begin to burn fat.

The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy.

It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned.

In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis

How do I test for ketones?

Ketone testing can be carried out at home.

The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels.

You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago.

Who needs to be aware of ketones?

The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis:

  • Anyone dependent on insulin – such as all people with type 1 diabetes
  • People with type 2 diabetes that are taking SGLT2 inhibitors (such as Forxiga, Invokana and Jardiance)

It is essential to know what the symptoms are, and when you should test for ketones. Finding high levels of ketones present in your urine is a sign that the management of your diabetes needs adjusting.

Ketone testing will be important within pregnancy for anyone with diabetes on insulin. Pregnant women with type 2 diabetes or gestational diabetes that is not treated with insulin should contact their health team if experiencing the symptoms of ketoacidosis.

Transcript

Ketones are a compound that can provide the body with energy. Ketones are produced when the body breaks down fats and protein. The usual reason for ketones being produced is when the body has used up its stores of sugar.

The NHS states that without sugar available, the body needs to find energy from another source, so it breaks down fat to make ketones for energy.

In type 1 diabetes, there is another reason why ketones are produced – high blood sugar or hyperglycemia Strictly speaking, it’s actually the lack of insulin for why ketones are produced in type 1 diabetes.

The body has loads of energy in the form of sugar, but without having insulin, the glucose can’t get into the cells to provide energy. As a result, the body switches to providing a different means of energy – ketones.

As with many things in the body, ketones are safe as long as the body doesn’t produce too much. Long term research studies, such as an 8 year study carried out by Johns Hopkins Children’s Center, have showed that ketones are not inherently dangerous at low levels.

For most people, high ketone levels are relatively rare. But people with type 1 diabetes, however, are at a greater risk, especially if blood glucose levels go too high.

Ketoacidosis is a dangerous state which happens if ketone levels become high.  The signs of ketoacidosis include dehydration, laboured breathing and vomiting. Ketoacidosis, because it’s dangerous, should be treated as an emergency and calling for medical help is advised.

You can test for ketones and this is something which people with type 1 diabetes can find useful. Diabetes advise ketone testing for people with type 1 diabetes during illness if blood glucose levels go over 15 mmol/L.

Ketone tests can be done with urine test strips and some special blood glucose meters also test for ketones. If high ketone levels won’t come down, contact your health team for advice.

Download a FREE ketone levels chart for your phone, desktop or as a printout.

Ketones and weight loss

As noted above, ketones are produced when the body burns fat. Therefore people that are losing a significant amount of weight may experience higher than normal ketone levels.

Ketone testing has also become used by people with type 2 diabetes on ketogenic diets to assess whether they are burning fat effectively. Use of ketone testing in this way is not recommended by the NHS and so ketone testing strips prescribed by doctors are not to be used for this purpose.

Ketogenic diets are not usually recommended for people with insulin dependent diabetes as aiming for higher ketone levels could present a higher risk of ketoacidosis occurring.

When should I test for ketones, and how will this affect the management of my diabetes?

The following information is of relevance to people who need to take insulin.

  • Blood glucose levels rise above 17 mmol/L
  • Blood glucose levels are consistenly above 13 mmol/L
  • If blood glucose levels rise in response to illness
  • If you notice symptoms of ketoacidosis such as vomiting or suffering from diarrhoea

If you record high levels of ketones, contact your health team immediately for advice on how best to manage your diabetes.

I think I might have diabetic ketoacidosis, how would I know?

If you are suffering from diabetic ketoacidosis the early signs are likely to include:

  • Stomach pains
  • Nausea and/or vomiting
  • Breathlessness
  • Breath that smells fruity

In this instance, call your doctor as soon as possible as ketoacidosis is an extremely severe condition.

90,000 Urinalysis for ketones (determination of acetone)

Description Preparation Indications Interpretation of results

Ketonuria – excretion of ketone bodies in the urine. This condition is pathological, since ketone bodies are not normally excreted in the urine. In the process of metabolism, a healthy person can release a small amount of ketones, but it is much less than the threshold values ​​and is not detected by analyzers.

Ketone bodies include: acetone, beta-hydroxybutyric acid and acetoacetic acid.The main metabolite is acetone, based on which the analysis of urine for ketones is based.

When do ketone bodies appear in urine?

Under normal conditions, the human body draws energy from glucose – when it breaks down, ATP molecules are released – the main energy substrate of the cell. But, in the absence of a sufficient amount of glucose, the body begins to receive energy by breaking down fats. A byproduct of fat breakdown is ketone bodies.

The formation of ketone bodies is possible with increased energy consumption – prolonged heavy physical exertion, feverish conditions, infections accompanied by persistent vomiting and diarrhea, with prolonged fasting.The combination of ketonuria with glucosuria (excretion of glucose in the urine) indicates the transition of diabetes mellitus to the decompensated stage (the risk of developing ketoacidosis and ketoacidotic coma). In diabetes mellitus, blood glucose is not absorbed by cells, due to their insensitivity to insulin, cell starvation occurs, as a result of which cells begin to break down fats.

Children are more prone to the formation of ketone bodies, since the stores of glycogen in children for obtaining glucose are much less.On the other hand, the energy requirements of a child are much higher than that of adults, so they need more glucose and when it is lacking, lipolysis (lipolysis) is activated. Urine analysis for ketones can be positive for severe infectious or other somatic diseases, malnutrition.

In pregnant women , urine analysis for ketones is necessary to diagnose early manifestations of preeclampsia. Ketonuria can worsen the course of pregnancy and negatively affect both the well-being of the pregnant woman and the growth and development of the fetus.

Why is ammonia dangerous?

An increase in the level of ammonia in the blood leads to the fact that it begins to penetrate into various organs and tissues and, first of all, into the brain. Ammonia is lipophilic, so the ammonia molecule can easily penetrate the lipid membranes of brain cells. An increase in the level of ammonia and its penetration through the blood-brain barrier is accompanied by various neurological symptoms, up to depression of consciousness and the development of coma. In children, hyperammonemia can be accompanied by a loss of skills and impaired neuropsychic development.

90,000 Ketones in urine 40. Ketones in urine analysis


Surely each of us has heard of such a phenomenon as acetone in urine. In scientific language, it is called ketonuria, or an increased content of ketone bodies in the body. What is this phenomenon and how is it dangerous for the body?

During the breakdown of fats or the formation of glucose in the liver of each person, three metabolic products are synthesized: acetone, beta-hydroxybutyric acid and acetoacetic acid
, which are called ketone bodies in medicine.In a healthy body, ketone bodies are excreted in minimal amounts (20-54 mg), and are not determined by conventional laboratory methods.

However, in some pathological conditions, the synthesis of ketones can increase significantly, as a result of which their accumulation occurs in the urine (ketonuria) and blood (ketonemia). In this case, qualitative reactions to ketones become positive, and the situation itself requires close attention, since it can serve as a symptom of a serious illness and lead to an acetone crisis – a dangerous condition that poses a threat to the patient’s life.

If we talk about the physiological mechanisms of ketonuria, then this phenomenon is associated with the breakdown of a substance called glycogen, which accumulates in the liver and is an energy reserve for the whole organism. With increased energy expenditure, severe stress, as well as some diseases, glycogen stores are depleted, and the body begins to receive the necessary energy from fat stores. It is the breakdown of fat that leads to the formation of ketones, which are excreted in the urine. The main causes of increased urinary ketone levels are as follows:

  • poor nutrition or prolonged fasting;
  • severe hypothermia, heavy physical activity and excessive protein intake;
  • flu, acute respiratory infections or other infectious diseases;
  • anemia;
  • oncological diseases;
  • diabetes mellitus;
  • pregnancy;
  • surgical interventions;
  • dysentery, as well as frequent and profuse vomiting.

Ketonuria is very often noted in women who are on diets or subject their bodies to prolonged fasting, as well as in athletes, bodybuilders, etc. In such cases, ketones in urine do not threaten a person’s health and life, but sometimes they are a serious reason to seriously reconsider your diet.

Another common cause of this phenomenon is diabetes mellitus. In this case, doctors say that the disease is progressing to a more severe stage.Moreover, the detection of ketone bodies in the patient’s urine can be a vivid symptom of an approaching hyperglycemic coma, so the person needs urgent assistance.

Finally, very often ketones in urine are found in severe poisoning, diseases that are accompanied by a prolonged increase in temperature, as well as after surgical interventions
… In this case, treatment depends on the causes of the disease, its severity, as well as on the individual characteristics of the patient’s body.

Diagnosis of ketonuria

One of the main symptoms of ketonuria is pronounced, coming from the patient’s urine or vomit, as well as the presence of this odor in his breath. Diagnosis of such a violation can be carried out both in the laboratory and at home.

To do this, you need to purchase special test strips, which are sold in the pharmacy without a prescription. In addition, there is another method for determining the level of ketones in urine – a few drops of ammonia solution must be added to the container with urine.If ketone bodies are present in the urine, it will turn bright red.

Ketonuria during pregnancy

Ketone bodies are also often present in urine in pregnant women, and are usually a symptom of severe toxicosis
(subject to normal nutrition and lack of physical activity). In addition, they can talk about the presence of an infection in the woman’s body, as well as diabetes and digestive problems.

In any case, the presence of ketones in the urine of pregnant women is regarded as pathological, and therefore requires further tests and medical advice.Ketone bodies can poison the body of a pregnant woman with acetone, which can significantly complicate the process of carrying a child.

Ketonuria in children

Ketone bodies in the urine of children are found more often than in adults, since their glycogen store is rather small, so the process of destruction of fats begins earlier. In this case, ketonuria can be either a single phenomenon or a regular one. In the first case, the so-called acetone vomiting usually occurs, the main feature of which is the strong smell of acetone.

Such vomiting may be the result of impaired absorption of fats and carbohydrates, and is also sometimes noted in hyperexcitable children. In this case, you should urgently seek help, subsequently revise the child’s diet, reducing the content of fats and proteins in it. This condition is dangerous because the patient can very quickly develop an acetomic crisis: its precursors can be fever, lethargy, drowsiness, abdominal pain, etc.

If acetone vomiting is repeated regularly in the baby, and ketone bodies are found in his urine, it is necessary to undergo detailed diagnostics, excluding diseases such as diabetes mellitus, brain tumors, intestinal infections and liver damage.

The main cause of urinary ketone bodies in newborns is insufficient feeding
, as well as such a type of ketonuria as leucinosis. This is a serious congenital disease that occurs in one child in thirty thousand. It is very difficult, accompanied by disorders of the central nervous system, decreased muscle tone and developmental disorders, and usually ends in death.

Treatment of ketonuria depends on its causes and the individual characteristics of the patient, and should be carried out under the strict supervision of a physician.In addition, people suffering from an increase in ketone bodies should follow a few simple guidelines:

  • A similar phenomenon is often observed in people who are obese. They need to organize fasting days for themselves (once or twice a week) in order to avoid an acenotomic crisis.
  • These patients should always have test strips on hand to monitor their condition. During the test, urine must be fresh (up to 4 hours), otherwise you can get a false positive result.
  • At the first sign of vomiting, you should stop eating and start taking small portions of alkaline mineral water every 15 minutes. If vomiting does start, you should immediately call an ambulance
  • Patients suffering from ketonuria (especially children) are recommended to carry out cleansing enemas once a week, and use smecta, enterosgel, etc. to remove toxins from the body.
  • Ketone bodies in diabetes mellitus indicates the progression of the disease, and the patient must not only change his diet, but also consult a specialist about adjusting the dosage of insulin.

Contents


Ketonuria is the presence of ketones in the urine (trace ket). Pathology is characterized by the smell of acetone and warns of infection in the body. Acetonuria has been linked to poor diet, but there are other reasons as well. If you do not seek help in time, the forecasts can be disappointing.

What are ketones in urine

In case of pathological conditions of the body, ketone bodies are detected in the analysis. In a healthy person, they are present in small quantities, but very insignificant, so they cannot be detected.Ketone bodies are excreted:

90 120 90 039 through sweat;

  • through exhaled air;
  • with urine.
  • Ketones are metabolic products that are synthesized in the liver (beta-hydroxybutyric acid, beta-hydroxybutyrate, acetoacetic acid, acetone) through the breakdown of fats or the formation of glucose. When the body is working properly, ketone bodies are deactivated without harming the surrounding cells. What does acetone in urine mean:

    • If ketone in urine is present in high concentration, the normal functioning of the body is at risk.
    • With an increased rate of fat metabolism, ketones are formed faster than the liver can eliminate them.
    • In medicine, this metabolic disorder is called “ketosis” and leads to the process of “acidification” of the blood.

    Causes of acetone in urine

    A healthy body does not contain the amount of ketones that can be determined by general analysis. Their appearance or the acetone smell of urine may indicate a threat to normal life.This serves as a warning: you need to adjust your lifestyle. For example, patients with diabetes may have this pathology. You can get rid of the symptom with the right diet. If the smell of urine is strongly pronounced and resembles apple or fruit, then in patients with diabetes, the level of glucose is increased.

    The consequences can be much more serious – the detection of ketones can warn of the transition of the disease to a dangerous stage up to hyperglycemic coma. If acetone without glucose is found, then this is a disease that is not associated with diabetes.Medical causes of ketonuria:

    • prolonged fasting;
    • 90,039 low-carb diets;

    • increased protein intake;
    • strong physical activity;
    • influenza and viral infections;
    • pregnancy.

    Acetone in urine in adults – causes

    With ketonuria, there is a lack of carbohydrates, which are necessary for the complete breakdown of proteins and fats. If acetone is formed in diabetes, then diet will help.Improvement on the background of proper nutrition does not come? Then it is possible that the patient has a severe metabolic disorder. Ignoring the symptom can result in a diabetic coma. If a person does not have diabetes mellitus type I and II, then there are other causes of acetone in the urine of an adult:

    • eating a lot of protein and fatty foods;
    • 90,039 lack of food rich in carbohydrates;

    • increased physical activity;
    • prolonged fasting.

    Ketone bodies in urine during pregnancy

    The increased content of ketones in a pregnant woman is characterized by a negative effect on the body. How to determine the presence of infection and not harm the unborn child? It is necessary to pass an analysis that determines ketones in urine during pregnancy. The release of biological substances occurs in an amount of 20-50 mg per day, which is the norm during pregnancy. Obstetricians-gynecologists insist on frequent urine sampling for a reason.

    Compliance with this rule will help you find out about possible problems and get rid of them:

    1. The presence of ketones in a pregnant woman will report problems with the liver and digestive system due to poor nutrition.
    2. With an increased amount of ketones, the body of the expectant mother is poisoned with acetone, thus complicating the process of bearing the fetus.
    3. Uneven indicators can be when a woman is losing weight with toxicosis in the first months of pregnancy.

    Ketone bodies in the urine of a child

    Almost every parent has encountered this problem. Ketones in a child’s urine can manifest through vomiting, which will smell like acetone. Among the common causes of ketonuria in a child are malfunctioning of the pancreas, poor nutrition, impaired absorption of carbohydrates and fat metabolism.An increase in performance requires a visit to a doctor. The child’s body signals a failure. The main causes of the appearance of ketone bodies in urine:

    • overwork at the physical level in hyperactive babies;
    • high temperature;
    • hypothermia;
    • serious pathologies provoking acetonuria;
    • hereditary factor;
    • 90,039 frequent use of antibiotics;

    • fasting or insufficient nutrition that triggered a decrease in glucose levels;
    • 90,039 diathesis;

    • excess of proteins and fats;
    • increased load on the body due to previous diseases;
    • stress;
    • worms;
    • enzyme deficiency.

    Urine analysis for acetone

    To identify acetonuria, you need to contact a therapist who will write out a referral for a general urine test. Together with other indicators, it will be possible to find out the presence and content of ketones. The procedure must be carried out according to the rules: collect morning urine in a clean and dry dish, having previously performed hygienic procedures. Acetone cannot be detected by conventional laboratory methods, since its concentration is very low. If the analysis of urine for ketone bodies showed the presence of acetone, then its amount will be indicated as follows:

    1. With one plus, the reaction is considered weakly positive.
    2. Up to three pluses, the reaction is positive.
    3. With four pluses, we can talk about the need for immediate medical attention.

    Norm of acetone in urine

    The human body is endowed with a certain amount of acetone, but the norm of ketone bodies in the urine is their complete absence in the usual laboratory analysis. In the diagnosis, color tests of Gerhard, Lange, Lestrade, Legalal are used. If the test result is positive, then you need to find out the number of ketone bodies, which will help determine the disease:

    1. Slight acetone is indicative of ketonuria.
    2. If the ketone value is between 1 and 3 mmol / L, then you have ketonemia.
    3. A result of 3 mmol / l indicates ketosis in diabetes mellitus.

    Norm of acetone in urine in a child

    When passing routine clinical tests in small patients, the norm of ketone bodies in the urine of a child should be zero. However, if ketones are present, then a rapid test will help determine their amount at home. The presence of ketone bodies is indicated by crosses or pluses (from 1 to 3), which tell about the amount of acetone:

    1. One cross is equal to a value from 0.5 to 1.5 mmol / L and indicates a mild degree of acetonemia.
    2. Two crosses indicate a moderate degree of pathology, which requires complex therapy (4-10 mmol / l).
    3. When three crosses appear, the child needs to be urgently hospitalized, this is a severe degree (from 10 mmol / l).

    How to determine acetone in urine

    Today, it is not at all necessary to resort to medical methods to test and control acetone. A test for the determination of ketone bodies, which can be bought individually at the pharmacy, will help to check acetone in urine at home.To check the indicators in dynamics, it is better to purchase several test strips at once. It is necessary to collect the morning urine and moisten the indicator zone with it.

    It is convenient to do this if you first collect the biological material in a container and simply lower the strip for 3 minutes. Another way to determine the level of ketones in urine without visiting medical institutions is a solution of ammonia. A few drops should be added to a bowl of urine. Problems are indicated by a color change to bright scarlet.

    Test strips for ketone bodies in urine

    Keto tests – test strips that look like sensory (indicator) strips. They can be used to perform a semi-quantitative and qualitative measurement of ketones in urine. The strips are available in packs of 5 to 100 pcs. For clinical laboratories, there are packs of 200. Packs for 50 pcs. enough to check acetone 3 times a day for 2 weeks. It is better to buy strips for the determination of ketone bodies in pharmacies than to order a cheap, but not certified product.

    What do ketone bodies in urine mean?

    The interpretation of the analysis result depends on the method of its implementation. What do traces of ketone bodies in urine mean? Only a doctor can tell a specific diagnosis. In home tests, after adding urine, the indicator zone will acquire a color, according to which an approximate result is given. The test shows the concentration of ketones from 0 to 15 mmol / L, but you will not see the exact numbers. If you find a purple tint on the test strip, the situation is critical. If, after adding drops of ammonia, the urine turns bright red, then there are ketones.

    Ketone bodies in urine – what to do

    If a general analysis for biochemistry or a rapid test showed the presence of ketones, then measures must be taken to reduce the indicators. To control the effectiveness of the selected measures, it is necessary to repeat the diagnosis after 3 hours. What to do if there is acetone in the urine? First of all, go to the doctor and follow the prescribed diet, lead a healthy lifestyle, try not to eat fatty and heavy foods.

    How to remove acetone from urine

    In case of acetonuria, one should try to reduce the elevated acetone in the urine.How? It is necessary to maintain a correct daily routine and eat healthy food. With very high numbers, only hospitalization of the patient is indicated. The doctor prescribes treatment, drinking plenty of fluids, and a strict diet. You need to drink water for 1 tsp. every 15 minutes. If an adult or child cannot do this due to vomiting, then intravenous drip of fluid is prescribed to prevent dehydration. Products and preparations such as:

    can help

    • decoction of raisins and other dried fruits;
    • solutions of drugs Orsol and;
    • chamomile infusion;
    • non-carbonated alkaline water;
    • 90,039 injections;

    • absorbents Sorbex or White coal;
    • cleansing enema (1 tbsp.l. salt per liter of water).

    Diet for ketonuria

    In addition to taking medications, an exhausted patient’s body needs a proper diet, which contributes to treatment and a speedy recovery. The correct diet with acetone in the urine, suitable for your body, is prescribed only by the attending physician. How to reduce the indicators of ketone bodies? Among the general recommendations of treatment, one can single out a diet that includes the use of:

    90,038

  • lean meat;
  • porridge;
  • 90,039 fermented milk products;

    90,039 compotes, green tea, homemade lemonade;

    90,039 vegetables;

    90,039 walnuts and hazelnuts;

    90,039 vegetable soup and borscht.

    Video: Glucose and ketone bodies in urine

    Attention!
    The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

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    Discuss

    Ketone bodies in urine – what does it mean: causes and treatment

    The following ketone bodies are of diagnostic value: acetocetate, acetone and beta-hydroxybutyrate.They are metabolic products of fatty acids and are synthesized from acetyl-CoA in liver cells.

    Normally, ketone bodies are constantly present in biological fluids of the body in negligible amounts (plasma acetone 1-2 mg%), about 20-50 mg are excreted in the urine per day. Such an amount is not detected by ordinary samples. If acetone and other ketones are detected in a general urinalysis, it is important to see a doctor immediately.


    Ketonuria and ketonemia

    Ketone bodies provide energy metabolism along with glucose.They are a kind of fuel for myocytes, brain, internal organs (except for the liver, erythrocytes) under extreme conditions for the body: hunger, exhaustion, dehydration, severe physical exertion.

    When the concentration of metabolic products of fatty acids in the blood increases (0.5 mmol or more), this condition is called ketonemia. It occurs when the formation of ketones is significantly higher than their utilization.

    Exceeding the normal concentration (more than 0.5-1 mmol / l) is called ketonuria.Acetoacetate and beta-hydroxybutyrate are predominantly excreted in the urine.

    Acetone is excreted to a greater extent with exhaled air, in urine its concentration is the lowest in comparison with the content of other ketones.

    Acetone is the strongest cell poison. A slight excess of the norm provokes the onset of pathological symptoms from the respiratory system, heart, digestive or nervous systems.

    An increase in the amount of acetone in urine (acetonuria) is primarily associated with a relative lack of glucose, when the cell’s need for energy increases significantly.The result of such starvation is the breakdown of glycogen (glucose store), the mobilization of a large amount of fatty acids from the depot.

    Interesting! The sweetish smell of acetone when breathing appears with ketonemia (more than 10 mg% acetone in the blood) and ketonuria (detection of ketones in urine)! Often found in diabetics with decompensation!

    2.
    Ketone bodies in urine

    A sharp decrease in the intake of carbohydrates (glucose) into the cells of the body causes a chain of chemical reactions:

    1. 1
      Breakdown of glycogen in muscles, liver or other tissues with the release of glucose.
    2. 2
      Glyconeogenesis (synthesis of sugar from non-carbohydrate components such as lactic acid).
    3. 3
      Lipolysis (breakdown of fat to form fatty acids).
    4. 4
      Fatty acid metabolism with the formation of ketones in the liver.

    Thus, a decrease in blood glucose levels triggers a series of complex reactions aimed at maintaining the energy balance of cells.

    The following are conditions that lead to the accumulation of ketone bodies in the body and their excretion in the urine:

    1. 1
      Diabetes mellitus type 1 or 2
      (stage of subcompensation, decompensation, diabetic hyperosmolar coma).
    2. 2
      Complete or Nearly Complete Carbohydrate Restricted Diet
      , excess of fats, proteins, strict fasting, prolonged fasting (exhaustion).
    3. 3
      Febrile diseases
      , occurring with high body temperature or sharp fluctuations in it (for example, typhoid, malaria). In children, any fever can cause ketones to accumulate in the blood and urine.
    4. 4
      Infectious Diseases
      (especially acute intestinal infections with diarrhea, vomiting, impaired absorption of carbohydrates).
    5. 5
      Massive injuries with damage to muscle tissue
      , crash syndrome, heavy operations.
    6. 6
      Acute alcohol poisoning
      , isopropyl alcohol, heavy metal salts, organophosphorus compounds, drugs (for example, salicylates).
    7. 7
      Neoplasms
      hormone-producing organs (thyroid gland, adrenal glands, pancreas), endocrinopathies (acromegaly, Itsenko-Cushing’s disease and syndrome, thyrotoxicosis, cortisol deficiency).
    8. 8
      Operations and brain injuries
      , subarachnoid hemorrhage.
    9. 9
      Physiological conditions
      (any trimester of pregnancy, postpartum, lactation, newborns up to 28 days). In pregnant women, ketonuria can occur at any week, especially in the early stages (with severe toxicosis) and in the third trimester (with gestosis, gestational diabetes).
    10. 10
      with severe overstrain of the muscular system (often in men, athletes).
    11. 11
      In children, ketonuria can be triggered by overwork
      , uric acid diathesis, infections, poorly selected milk formula, mental illness and other reasons. A change in diet (refusal of carbohydrates while taking ketogenic foods) in combination with overwork, overexertion, an acute infectious disease can also cause ketonuria and acetonemic vomiting.
    12. 12
      Older age (over 70 years old)
      with many chronic diseases.

    3.
    The main symptoms

    With a high level of ketones in the body, the patient has the following symptoms:

    1. 1
      Asthenia, muscle weakness, decreased performance, attention, reaction speed, drowsiness, lethargy.
    2. 2
      Thirst, dry mouth, complete lack of appetite, aversion to food.
    3. 3
      Nausea, repeated vomiting.
    4. 4
      The smell of acetone from the mouth (sweat, urine do not always smell like acetone).
    5. 5
      Severe headache, abdominal pain.
    6. 6
      Increased body temperature, dry skin and mucous membranes, bright blush.
    7. 7
      Increased heart rate.
    8. 8
      Enlargement of the liver (temporarily).

    Sometimes there is a spontaneous normalization of the blood acetone level, the cessation of its excretion in the urine, the improvement of the patient’s condition.

    If the severity of symptoms increases (for example, in patients with diabetes, pregnant women), then more formidable signs appear: lethargy, dehydration, toxic damage to the central nervous system, acidification of the blood (pH shift towards the acidic side), disruption of the heart, kidneys, convulsions, coma, death.

    Ketoacidosis develops, as a rule, suddenly, after exposure to some provoking factor (excess of fatty foods, fever, acute stress).

    4.
    Diagnostics

    Diagnosis is based on clinical signs, as well as laboratory detection of acetone, beta-hydroxybutyric, acetoacetic acids in urine.

    At home, you can determine the level of ketones with special test strips with a reagent applied. The color change according to the corresponding scale indicates the concentration of ketone bodies.

    There are a lot of test strip manufacturers: Biosensor-AN LLC (Ketoglyuk-1, Uriket-1), Abbott, Bioscan, Lachema, Bayer, etc. Their sensitivity is different. Detection of ketones at a concentration of 0-0.5 mmol / L is considered the norm.

    Table 1 – Comparison of test strip scales from different manufacturers

    In addition, glucose or other components of urine can be detected in the same way. Laboratory diagnostics are undeniably more accurate. Reference values ​​(Invitro) – less than 1 mmol / L.Ketones, the concentration of which in the urine is below this level, are not detected in the study.

    Important! If, in addition to ketone bodies, glucose is found in the analysis of urine, then diabetic ketoacidosis should be suspected in a person! This condition requires immediate medical attention!

    Additionally, the level of ketones in the blood is diagnosed, a biochemical analysis is performed, and an ultrasound examination of the abdominal organs is carried out.

    5.Treatment activities

    Therapy is aimed at relieving symptoms (vomiting, headache, dehydration), reducing the level of acetone. Depending on the severity of the patient’s condition, treatment is carried out at home or in a hospital. Sometimes the patient needs to be admitted to the intensive care unit.

    1. 1
      If the patient is diagnosed with diabetes mellitus, then it is necessary to correct the glucose level, insulin therapy, infusion therapy. After removing from ketoacidosis, the selection of therapy with hypoglycemic drugs is carried out, the patient is told about the diet and lifestyle.
    2. 2
      In case of temporary disturbance of fat metabolism, a carbohydrate diet is prescribed to restore the energy balance.
    3. 3
      Acute intestinal or other infections are treated with antibacterial, antipyretic agents with the addition of sorbents, saline solutions (Regidron, Orsol, glucose solution), alkaline drinks (mineral water) to eliminate dehydration.
    4. 4
      With alcoholic ketoacidosis, it is important to replenish glucose deficiency, eliminate dehydration, and restore acid-base balance.This is achieved by intravenous administration of dextrose and salt solutions (Ringer, saline, sodium bicarbonate).
    5. 5
      Sometimes it is enough for a child to replace the milk mixture, to carry out adequate treatment of uric acid diathesis, to eliminate all provoking factors. Over time, ketone bodies will stop appearing in the urine. A balanced diet is of great importance. The diet should be balanced in terms of the main components: proteins, fats, complex and simple carbohydrates, multivitamins, minerals.
    6. 6
      It is important to note that acetone crises in children can recur, therefore, in order to prevent them, it is necessary to identify the cause of excessive ketogenesis.This will require additional research, the list of which is determined by the attending doctor after a conversation and examination.
    7. 7
      When it appears, especially at a later date, treatment is indicated in a hospital setting, the normalization of carbohydrate metabolism, nutrition. It is important to exclude fatty meats, spicy foods and smoked meats, broths, butter, lard, mushrooms, cocoa and other ketogenic products from consumption. Food should contain easily digestible carbohydrates, vegetables and fruits.

    Ketone bodies or ketones are organic compounds produced by the liver.These include acetone, acetoacetic and beta-hydroxybutyric acid. Excessive formation of these substances causes their accumulation in the blood and penetration into the urine. This condition in medicine is called ketonuria or acetonuria, and in the people – acetone in the urine. What this means and how serious the problem is, the doctor will help to determine with the help of a group of tests.


    Standards

    The human body draws energy mainly from glucose, which accumulates in the liver in the form of a special substance – glycogen.If glycogen stores are not enough, energy is obtained from fats, which are broken down into ketone bodies. They are quickly excreted in the urine, and due to their low concentration, they are practically not determined by laboratory methods. Normally, the amount of acetone excreted in the urine is 20-50 milligrams per day.

    Ketone bodies can be identified using a general urine test. For the study, you need an average portion of morning urine placed in a sterile container. The results obtained are deciphered as follows:

    • Negative reaction
      – the number of ketones does not exceed 0.5 millimoles (or 5 milligrams) per 1 liter of urine.
    • Weakly positive (+)
      – no more than 1.5 millimoles (15 milligrams) per liter of urine.
    • Positive (++ or +++)
      – The concentration of acetone is 1.5-4 millimoles (15-40 milligrams) per liter.
    • Strongly positive (++++)
      – The level of ketone bodies reaches 10 millimoles (100 milligrams) per liter of urine.

    You can also use test strips to determine the concentration of ketone bodies, which should be dipped in the collected urine.When acetone gets on the indicator zone with the applied reagent, it is colored, after which the result can be compared with a special color scale. The convenience of this analysis is that it can be done quickly at home.

    If the concentration of ketones is slightly increased, they speak of a slight deviation from the norm, which does not require treatment. With a significant increase in the level of acetone in the urine, it is necessary to find out the cause of the pathology and determine actions to eliminate it.

    Reasons

    In adults

    Ketonuria is a consequence of a violation of fat and carbohydrate metabolism in the body, the causes of which may be:

    • Increased energy consumption due to excessive physical, mental, emotional stress.
    • Improper diet with a large amount of protein foods and a lack of carbohydrates.
    • Eating foods containing ketogenic amino acids – phenylalanine, tyrosine, isoleucine, leucine.
    • Dehydration of the body. It can occur in diseases with fever, diets or starvation, poisoning with severe vomiting or diarrhea.
    • Insufficiency of the enzymatic function of the liver and pancreas, which leads to metabolic disorders and the accumulation of ketones in the blood and urine.
    • Diabetes mellitus in the stage of decompensation. Usually, together with acetone in the urine, an increased level of glucose is detected.
    • Alcoholic ketoacidosis – when ketones accumulate in the blood due to the constant use of alcohol, the body tries to excrete them in the urine.

    • Cancer lesions and inflammation of the gastrointestinal tract, intestinal infections entail a violation of the absorption of nutrients, which negatively affects metabolic processes in the body.
    • Tumors of the adrenal and thyroid glands – elevated levels of corticosteroid hormones accelerate the metabolism of fats and the process of glucose formation from them.
    • Thyrotoxicosis – an excess of thyroid hormones contributes to the rapid consumption of carbohydrates from the blood.
    • Development of esophageal stenosis – a decrease in the diameter of its lumen, disrupting the normal passage of food.
    • Recovery period after general anesthesia.

    During pregnancy

    Periodic detection of traces of ketones in the urine of a pregnant woman is not a pathology and can be caused by an increase in the load on the body or toxicosis in the first half of pregnancy, which is accompanied by frequent vomiting.

    In this case, the doctor may advise to minimize activity, observe the drinking regime, and adjust the diet. Meals should be fractional and frequent, and it is also necessary to increase fluid intake, preferably in the form of electrolyte solutions.

    The appearance of acetone in urine at a later date, especially in the third trimester, may indicate gestosis, a serious complication of pregnancy that requires increased attention from doctors.

    In a child

    Glycogen stores in children are much less than in adults, so the breakdown of fats for energy begins with significantly less energy loss, as a result of which acetonuria is often detected in urine analysis.Usually this phenomenon is observed in children 1-12 years old, it can be triggered by impaired absorption of carbohydrates and fats, viral infections, physical activity, emotional stress, stress, strong emotions (even of a positive nature).

    In newborns, an increase in urine ketone bodies is almost always caused by insufficient feeding. There is also a rare (1 in 120-300 thousand children) hereditary disease – leucinosis or branched-chain ketonuria – in which metabolism is disturbed, the nervous system is depressed, developmental delay, ketone bodies are found in the blood, and the smell of urine resembles maple syrup.This disease is very difficult and often fatal.

    Ketonuria in children can be either permanent or single. In the latter case, it is often accompanied by acetonymic vomiting, a feature of which is the previous smell of acetone from the oral cavity, from urine, and then from vomit.

    Treatment

    To reduce the level of ketone bodies in urine, it is necessary to find out the root cause of this condition and eliminate it:

    • Normalize and balance nutrition.The diet should contain easily digestible carbohydrates and a minimum amount of fat.
    • Optimize workloads, both physical (during bodybuilding and sports) and psychological (during exams, with heavy workload), eliminate stress.
    • Observe the regime of the day and rest (walks, healthy sleep, regular non-tiring physical exercises).
    • Identify possible illnesses and treat or control them.
    • For diabetic patients, acetone in the urine indicates progression of the disease and requires an adjustment in insulin levels.
    • People prone to ketonuria should do a cleansing enema at least once a week.

    Ignoring the problem can cause an acetonymic crisis when elevated acetone levels cause fever, abdominal pain, and vomiting. In this condition, many patients require hospitalization and intravenous fluids.

    The main objectives of the treatment are:

    • Replenishment of the stock of trace elements – for this, electrolyte solutions (Regidron, Humana Electrolyte) are used orally or in the form of an enema, mineral waters (Borzhomi, Luzhanskaya).
    • Elimination of dehydration after vomiting – preferably by desoldering a few sips of liquid every 5-10 minutes. In addition to the above solutions and waters, it can also be dried fruit compotes, sweet fruit juices, sweet lemon tea.
    • Stopping the toxic effects of ketone bodies on the body – bowel cleansing with an enema, the use of enterosorbents (Smecta, Fosfalugel, Enterosgel).

    Delaying treatment for ketonuria can be fatal.

    Ketone bodies (acetone bodies) are a natural decomposition product. They are constantly formed in human blood plasma. In a healthy body, their production is so small that they do not cause any harm.

    Ketone bodies enter the kidneys through the filtration system from the blood. It is almost impossible to identify a small number of them in a laboratory way. But if the increase in ketone bodies in the analysis of urine is significant, this indicates a pathological process in the body.

    An increased level of ketone bodies in urine (ketonuria) occurs in the body against the background of a lack of glucose.This condition can be caused by various factors: diabetes mellitus, starvation, increased psycho-emotional and physical activity, alcohol intoxication, poisoning.

    If ketones are found in urine, the causes of which are unknown, it is necessary to urgently take measures to remove them from the body and establish what caused ketonuria. This will allow for the correct therapy and quickly normalize the level of acetone in the urine.

    Ketonuria in adults is most often an indicator of the development of diabetes mellitus.But there may be other reasons for this condition. In 90% of cases, ketones in urine appear in pregnant women and children under 12 years of age.

    Ketonuria is not a problem for children if acetone disappears in the urine upon repeated examination. Usually the doctor prescribes a special diet and drugs to cleanse the body, and after a couple of days the analysis is repeated. If there are no serious pathologies, acetone in the urine is not re-detected.

    Adults rarely ask themselves what ketone bodies in urine are, but if such indicators appear in the analysis, this indicates the development of a pathological condition, and requires urgent corrective measures.Acetone, which accumulates in the liver in an adult, can be life-threatening.

    In the analysis of urine, the presence of ketone bodies is indicated by the symbols KET. An excess of the norm of ketones in urine will be indicated by an analysis in which the KET indicator is higher than 0.5 mg.

    An express method to determine if ketones in urine are elevated is also available at home. Pharmacies sell tests for self-diagnosis of urine pH levels. The test strip, upon contact with urine, in the presence of ketones, turns into a color, which must then be compared with a color scale.

    When acetone appears in urine, the range of possible shades on the test strip ranges from light pink to lilac. The richer the color, the more acidified the urine, which indirectly indicates an increased content of ketone bodies.

    It is important to know that diabetes mellitus will be indicated not only by a high concentration of ketone bodies in the urine, but also by an excess of glucose levels.

    Developing diabetic ketoacidosis will be indicated by urinalysis with an increased ket value and a high sugar content.This condition indicates a long-term insulin deficiency and excessive formation of metabolic products.

    Causes of ketonuria

    An increased content of acetone in the urine can indicate both temporary disruptions of certain processes in the body, and a serious pathology. Traces of ketones are found in urine in adults and children against the background of the following conditions:

    • fasting and long-term diet;
    • violation of fat and carbohydrate metabolism;
    • 90,039 intense physical activity;

    • hypothermia or heatstroke;
    • developing anemia;
    • 90,039 viral and infectious diseases;

    • diabetes mellitus;
    • hematopoietic disorder, blood leukemia;
    • neoplasms in the brain;
    • oncological diseases of the gastrointestinal tract;
    • intoxication with salts of heavy metals;
    • 90,039 taking certain medications;

    • vomiting;
    • Chronic alcohol dependence, leading to destructive changes in the liver.

    The reason for the appearance of KET in the analysis of urine can be a carbohydrate-free diet, prolonged fever, poisoning and infectious bowel diseases.

    Patients after surgery are also at risk, since the breakdown of blood proteins in the wound surface increases, and anemia resulting from blood loss can aggravate the process. Ketones in urine can appear against the background of insufficient fluid intake, as well as when eating a large amount of animal products.

    But this is not a complete list of reasons why ketone bodies can appear in urine. Many other pathologies can cause acidosis, therefore, conclusions cannot be drawn without examination and consultation with a specialist.

    Ketonuria in children

    The reason for the detection of acetone in urine in children is most often overwork, stress, emotional overload, a long trip. Acidosis also occurs against the background of viral, infectious diseases, intestinal infections, especially if the disease is accompanied by high fever or frequent vomiting.

    In addition, ketones in the urine of children under 12 indicate insufficient fluid intake in the body, as well as improper and unbalanced nutrition.

    A temporary and insignificant increase in the level of ketone bodies in children is easily corrected and most often is not the cause of serious pathologies.

    However, ketonuria in children can also indicate serious disorders in the body, such as a brain tumor, liver failure, diabetes mellitus, thyroid dysfunction.Therefore, it is important, when a KET indicator is found in the analysis of urine in a child, to conduct repeated studies to prevent the development of pathologies.

    Ketones in urine during pregnancy

    Normally, a pregnant woman should have no ketone bodies in her urine. If the analysis showed the presence of KET in the urine, hospitalization is most often indicated for a pregnant woman.

    Despite the fact that elevated acetone in a pregnant woman does not always indicate serious pathologies, only with an inpatient examination will doctors be able to find out exactly what this means, and why the ket indicator is present in the urine.

    Usually, in pregnant women, an excess of the norm of ketone bodies in the body occurs against the background of toxicosis, especially accompanied by frequent vomiting.

    Or ketonuria can develop against the background of gestosis (toxicosis of the last trimester) due to hormonal shifts and the consumption of large amounts of food rich in proteins and fats. In addition, pregnancy and this kind of pathology can be interrelated for the following reasons:

    • viral and bacterial diseases;
    • diabetes mellitus;
    • liver damage;
    • oncological diseases.

    The presence of acetone in urine can be hazardous to a pregnant woman. Ketonuria threatens not only the life and health of the child, but also the mother.

    This condition can lead to miscarriage, premature birth and even coma. If a pregnant woman does not feel well, notes severe fatigue, drowsiness, and at the same time ketones are found in her urine, this condition requires treatment in a hospital setting.

    Associated symptoms

    The process of excessive accumulation of ketone bodies in the body is accompanied by indirect signs that are easy to identify before the test.

    Ketonuria will be indicated by an unpleasant odor of acetone from the oral cavity, which may be accompanied by increased fatigue, nausea and even vomiting.
    In addition to these signs, children may also have symptoms of pathology such as:

    • decrease in physical activity;
    • pallor of the skin;
    • decreased appetite;
    • Abdominal pain in the navel area.

    The listed symptoms are sometimes noted against a background of increased body temperature (37-39 degrees).

    Diagnostics

    Diagnosis of ketone bodies in urine is an important medical study to identify the level of acetone intoxication in the body. Ketonuria in a neglected state can cause serious harm to a person, therefore, when acetone is found in urine, it is important to establish the exact cause of such a pathology.

    The final decoding of the general analysis of urine in the presence of ketone bodies in it should be carried out only by a doctor. Methods for diagnosing the presence of acetone in the body include not only urinalysis, but also a blood test, thanks to which it will be possible to determine a more accurate level of ketone bodies in the blood.

    Based on additional laboratory tests, the doctor will be able to determine whether diabetes mellitus is the reason that ketones were detected in the urine, or this pathology arose against the background of another disease.

    The cut-off value, which serves as an indication for further monitoring of the patient’s condition, is determined at the level of 0.5 mmol / l in blood tests. An indicator above 1-2 mmol / L will indicate prolonged intoxication with ketones.

    To confirm the diagnosis of diabetes mellitus, in addition to a general study of the level of ketone bodies in urine and blood, a blood glucose test is performed.If the determination of the glucose level did not show an excess of the norm, it will be necessary to look for another cause of the pathology.

    Treatment and diet for ketonuria

    The main goal of therapeutic therapy for ketonuria is to remove acetone from the body. Inpatient interventions include intravenous saline infusions and drug therapy. But hospitalization with an elevated level of ketones in the urine is not always necessary.

    It is possible to reduce acetone in urine at home. The first thing that is necessary is to detoxify the body with enterosorbents, as well as restore water balance.

    It is important to correct the condition and prevent further increase of ketones in blood and urine with the help of proper nutrition. The diet for ketonuria includes the following recommendations:

    • first of all, it is necessary to exclude from the diet fatty meat and dairy products, canned food, smoked meats and fast food;
    • prohibited alcohol, coffee, cocoa, chocolate;
    • it is desirable to remove mushrooms, tomatoes, citrus fruits from the menu;
    • it is useful to include in the diet food rich in fiber, as well as to use juices, fruit drinks, compotes from berries and dried fruits, to diversify the diet with cereals.

    Patients with diabetes mellitus are prescribed doses of insulin. With liver pathologies, drugs are shown that support the function of this organ. All patients, without exception, are advised to consume alkaline water (baking soda).

    If ketonuria is detected in time, correct therapy is carried out and nutrition is balanced, the prognosis for the correction of pathology is favorable.

    90,000 ketones in urine are normal – 25 recommendations on Babyblog.ru

    So, for the first time my daughter went to the hospital, and, of course, I was with her.In the last month, I noticed that my daughter did not have a special appetite, but somehow she did not pay special attention to this, in principle, she ate, but not as much as before. On Monday (I don’t remember the date, but I remember the day of the week) we went to IKEA for shopping, Melina was sent there to the children’s center, where all the kids play while their parents walk around the store. I took her away, everything is fine, we ate ice cream and a hot dog, as usual after visiting IKEA, and now, at night, Melina wakes up from the fact that she vomited. Well, okay, I think she ate something that made her sick.My daughter had the urge to vomit during the night, but there was nothing much to vomit, so a little bile came out. In the morning, Melina felt bearable, no vomiting, no diarrhea, but did not want to eat. I, I want to note, felt a strange odor from her mouth, as if it smelled like acetone, I went to the Internet to read, and found that it could be due to the fact that I had not eaten for a long time. And that’s all, I didn’t pay attention .. Then Melina fell asleep during the day, and slept for almost 4 hours, which never happens. I attributed everything to fatigue and what I vomited all the same was bad with my stomach.The next day, it was already Wednesday, in the morning my daughter asked for pasta, even ate them. She felt bearable, so it seemed to me .. In the evening I even asked her if you want to go to the playground, she wanted to, and we went. We stayed for 20 minutes, then went to the supermarket … In general, everything is as usual, nothing strange, except that I did not pay attention that my daughter did not drink water these days, and practically did not eat anything … but I blamed it on the consequences of vomiting.

    On Thursday morning, we had to go for tests, an annual check up.Melina slept for 12 hours somewhere, I pick her up, but she can’t wake up .. got up with difficulty. And five minutes later she falls back on the bed, and I see, immediately falls asleep .. Then I already smelled something was wrong .. I pick her up, she dresses and tries to go to bed again .. That’s it, I tell my husband that it’s time to go to the hospital. We get dressed, get into the car, Melina lies down in the back seat and falls asleep. I have tears. I am in a panic, I have never seen her in such a state that she fell asleep unconscious in the morning, at 11 in the afternoon. In general, we arrived at the hospital, I talked about the situation, about being asleep, about how I vomited once, about the smell of acetone from the child’s mouth.The doctor measured the sugar with a glucometer, and at a rate of 80, my daughter had 50 sugar, so she slept, the sugar level was very low. The doctor diagnosed gastroenteritis (probably so in Russian), and severe dehydration, the daughter was immediately hospitalized, immediately put on droppers of saline solution with dextrose, and she was under the dropper for three whole days, day and night.

    We did all the tests, and showed the presence of ketones in the urine .. Of course, I immediately began to read on the Internet that it might be, I read about acetone syndrome.I don’t even want to watch what is called correctly. The smell from the mouth went away after a day and a half, in general, the child immediately came to life, became cheerful, vigorous. But the most interesting thing is that on the day of discharge, in the morning, I woke up from nausea, vomited … got infected in general, in the evening, when we got home, my temperature rose … but that’s a completely different story …

    Even after I was discharged, I was haunted by where this acetone came from, what was wrong with my daughter, I read different sites, different articles.I was looking for why the blood sugar dropped so much .. And, to my delight, I opened an article by Dr. Komarovsky about acetone .. And everything became clear and understandable to me. Everything happened because of my ignorance, but alas, you cannot know and be ready for everything.
    In general, everything ended well, Melina began to eat as before only a week after she was discharged … But now I am ready for such a development of events, and with acetone and dehydration, I hope she will no longer get to the hospital

    90,000 Ketone bodies in urine – what does this mean in a woman during pregnancy?

    Urine analysis during the period of childbearing is often handed over – this is necessary to track changes in the woman’s body.If the analysis showed ketone bodies in the urine, this does not always signal a dangerous violation of pregnancy. Possible risks can be assessed by quantitative changes in this indicator. A slight increase in ketones is due to physiological changes, however, multiple excess of the normal value is a significant cause for concern.

    Material content:

    Ketone bodies in urine: what does it mean?

    Ketone bodies or ketone compounds is a collective term used to designate metabolic products that are formed by the liver: acetone, acetoacetic and beta-hydroxybutyric acid.

    The reason for the formation of these substances is a violation of the metabolism of fats and carbohydrates. Normally, glucose acts as a “fuel” for the body. The accumulation of this substance in the liver leads to the formation of glycogen – a kind of energy reserve. With a lack of glucose, which is released from carbohydrates, glycogen is consumed. In response to a deficiency of carbohydrates, the liver synthesizes special enzymes that convert glycogen back into glucose, which allows the body to provide energy even with a lack of intake of this substance from food.

    Under the influence of a number of negative factors, the amount of glycogen decreases. If this disrupts carbohydrate metabolism, the body has nowhere to draw energy, therefore proteins and fats are used as energy reserves. At the same time, ketones are found in urine – products of protein metabolism.

    Normally, these compounds are always present in the body, but due to their low concentration, which is not even detected in laboratory tests, they do not pose a danger. They are independently excreted with urine and do not accumulate in the body.Pathology is signaled by a violation of the rate of their synthesis, when the formation of new compounds exceeds the rate of their elimination.

    Norm in urine in pregnant women

    An increase in ketone bodies in the urine or ketonuria is a sign of pathology. Normally, daily urine contains about 10-30 mg of these compounds. They are gradually eliminated from the body and do not have a toxic effect on tissues.

    Normally, ketone compounds in urine should be completely absent from any person, including pregnant women.During the period of bearing a child, there is always a slight increase in ketones in the urine at the initial stages, which is due to toxicosis, due to hormonal changes in the body. A significant increase in ketones is a dangerous condition that requires a detailed examination to identify the cause and its subsequent elimination. As a rule, during pregnancy, drug treatment is not carried out, however, a special diet and regimen helps to normalize the level of ketones.

    Causes of ketonuria

    An increase in urine ketone compounds during pregnancy can be both a physiologically determined phenomenon and a manifestation of gestational disorders.

    Among the physiological causes of the disorder, there are:
    • abuse of protein foods;
    • physical stress;
    • lack of nutrition;
    • stress.

    Physiological ketonuria is a short-term and transient disorder. Ketones rise rapidly, however, to normalize the indicator, it is enough to change the diet and normalize the daily routine.

    Among the dangerous causes are infectious diseases, type 1 diabetes mellitus, endocrine disorders.All these violations are very dangerous. It is necessary to promptly identify the cause of the increase in ketone bodies in the urine. This is important both for the preservation of pregnancy and for the health of the woman.

    Gestational causes of ketonuria

    In addition to general physiological reasons, ketonuria can be triggered by changes occurring in the body against the background of bearing a child.

    Gestational increase in ketones due to:
    • hormonal changes in the woman’s body;
    • violation of taste sensations;
    • toxicosis in the early stages;
    • 90,039 pregnancy diabetes;

    • late toxicosis.

    Elevated acetone due to hormonal changes is a fast-passing phenomenon that does not require specific therapy and does not pose a danger. As a rule, a slight increase in ketones before the 17th week of pregnancy does not cause concern, but only in the absence of any accompanying symptoms.

    During pregnancy, due to hormonal changes, there is a change in taste. This is due to the production of hormones that stimulate the sensitivity of the taste buds.As a result of this change, many women change their diet, giving preference to protein foods.

    The formation of acetone in the urine observed against this background is directly related to the diet – the less carbohydrates enter the body, the more ketones are formed due to the breakdown of fats and protein compounds. To normalize these indicators and reduce the load on the liver, it is enough just to change the diet.

    If, a few days after adjusting the diet, re-take the test, you can find a complete absence of ketones in urine.

    Early toxicosis also provokes ketonuria. This phenomenon is fast-passing; treatment is not required. The danger to the health of the woman and the fetus is late toxicosis, which is found in the second half of pregnancy. Gestosis is accompanied by a number of disorders on the part of the nervous and cardiovascular system, which is caused by intoxication of the woman’s body. The violation requires timely detection and the adoption of therapeutic measures, otherwise the risk of miscarriage is high.

    Gestosis can be both a cause and a consequence of ketonuria.Such a complication is encountered in decompensated diabetes mellitus.

    Gestational diabetes is a violation of cell tolerance to glucose due to hormonal changes in pregnant women. The disease requires treatment, but in most cases it is possible to limit themselves to diet therapy.

    What is the threat of ketonuria?

    Ketone compounds are toxic substances that poison the brain and destroy tissues. An increase in their concentration leads to the development of a number of complications.First of all, the work of the liver, cardiovascular and nervous systems is disrupted.

    In the absence of timely treatment, ketonuria may result in:

    90 038

  • respiratory failure;
  • intoxication;
  • arrhythmia;
  • disorientation and disturbance of consciousness.
  • During the period of childbearing, gestosis against the background of ketonuria is especially dangerous. This condition can provoke a miscarriage, cause fetal intoxication, and cause pregnancy to fade.There are cases when, as a result of the strongest intoxication of the body against the background of gestosis, pathology led to death.

    How to find out the violation yourself?

    For self-diagnosis, special test strips are used, which can be easily purchased at any pharmacy. They allow you to detect the presence of ketones in the urine.

    Symptoms that suggest a violation are signs of toxicosis in pregnant women:
    • morning sickness with vomiting;
    • increased thirst;
    • decrease in blood pressure;
    • 90,039 loss of strength;

    • Constant sleepiness.

    The test strip should be used immediately after sleep by dipping it into the morning urine portion. In the presence of ketones, it changes color – the brighter the strip is, the higher the content of toxic substances.

    What to do when ketones increase?

    The principle of treatment depends on the concentration of ketones in the urine. With repeated excess of the norm and intoxication, it is necessary to remove these compounds from the body. For this purpose, a diffuse injection of a physical solution is shown.

    In most cases, no drastic measures are required. Balanced nutrition and adherence to the drinking regime allows to normalize the patient’s condition. Pregnant women are shown to eat often, every 2-3 hours, but in small portions. At the same time, it is important to avoid dehydration of the body. With elevated acetone, the doctor may recommend alkaline water, if there are no contraindications. In the diet, a restriction is imposed on fatty foods. It is imperative to normalize the daily routine, get enough rest and not neglect walks in the fresh air.

    As a rule, in the overwhelming majority of cases, it is possible to remove ketone bodies from the body a few days after changing the diet. Re-analysis of urine is prescribed 5-6 days after the start of treatment.

    Urine analysis, decoding

    People with diabetes require periodic urinalysis, firstly, to determine the presence of sugar in the urine, and secondly, to exclude urinary tract infections, which are common in patients with diabetes mellitus and must be treated without fail.

    Urinalysis is non-invasive and people often do it at home. However, healthcare providers may use a urine test if they cannot access a vein for blood tests, or if the person has anxiety or fear of needles.

    In this article, we’ll look at the types of urine tests for diabetes and how to understand the results.

    Types of analyzes

    A urine test can detect a variety of substances, including glucose, ketones, protein, bacteria, and bilirubin.

    Glucose

    In the analysis of urine, you can determine the level of glucose, ketones and other substances.

    Generally, glucose is not present in urine. However, when a person has diabetes, it can be detected in the urine. Some kidney diseases can also be accompanied by the appearance of sugar in the urine.

    Pregnancy:

    During pregnancy, almost half of women can detect glucose in the urine, even if they do not have diabetes.

    A woman who has urinary glucose during pregnancy should be screened for gestational diabetes.

    This is a type of diabetes that occurs during pregnancy and usually resolves after childbirth, but can have a negative effect on the fetus, lead to complications during childbirth and a higher risk of developing type 2 diabetes later in life.

    Glucosuria is the determination of glucose in urine.

    Ketones

    When a person has diabetes, the glucose in their blood cannot enter the cells of the body, and it remains in the blood. When this happens, the cells do not have enough glucose for energy.

    As a result, the body begins to break down fat to use it instead of energy. This produces toxic ketones. If ketone levels rise too high, they can cause the blood to become too acidic. In a person with diabetes, this can lead to diabetic ketoacidosis (DKA), which requires urgent treatment.

    Ketones can also pass into the urine, so a doctor may use a urinalysis to check for DKA. People with diabetes may have a urine test done at home if they begin to experience the signs and symptoms of DKA.

    DKA symptoms include:

    • “fruity” or acetone odor on breath
    • Frequent urination
    • thirst
    • dry or reddened skin
    • shortness of breath
    • confusion
    • abdominal pain
    • nausea and vomiting
    • high blood sugar
    • In severe cases, a person may experience:
      • o loss of consciousness
      • o to

    Anyone who thinks they may have DKA should first check their blood sugar levels.If they exceed 240 milligrams per deciliter (mg / dL), the ADA recommends testing for ketones.

    If ketone levels are high, seek immediate medical attention to prevent diabetic coma. This applies to patients with type 1 diabetes.

    The risk of DKA is higher when a person with diabetes develops SARS or the flu. During this time, according to ADA guidelines, they should check their ketone levels every 4-6 hours.

    Knowing about self-testing for glucose and ketones can enable a person with diabetes to better control their condition.

    Protein

    Your doctor may check your urine sample for protein. This is because diabetes increases the risk of chronic kidney disease (CKD) and, in particular, diabetic nephropathy. An early sign of diabetic nephropathy is protein in the urine.

    The earlier a person learns about kidney disease, the better the prognosis.

    Bilirubin

    Sometimes, urinalysis can detect bilirubin, a substance that can indicate liver damage and some other health conditions.

    A study published in 2017 finds a link between high bilirubin levels in people with diabetes and kidney disease, retinopathy and diabetic neuropathy, all common complications of diabetes.

    What to expect

    Sometimes a urinalysis is called a dipstick test because it involves dipping strips into urine and reading the results using a color scale.Home tests are like this.

    At the doctor’s office

    If the test strip changes color, ketones, glucose, or another substance may be present.

    In the doctor’s office, the healthcare professional will give you a clean and transparent container and ask you to do the following:

    • Pee a little first before filling the container as the sample in medium flow gives the most accurate reading
    • fill three quarters of the container and secure the lid
    • Return the sample to the doctor or place it at a designated location

    The doctor will dip the strip in urine, which will change color according to the level of various substances in the urine.

    The doctor will compare the strip to a color scale to determine the level of glucose, ketones, and protein in your urine.

    If the urine pH is high, it could indicate the presence of certain bacteria. However, the doctor may also need to send the sample to the laboratory for culture if they are testing for UTIs. This can reveal the type of bacteria present and give an idea of ​​what treatment to give.

    Home testing

    The procedure is slightly different if you are already diagnosed with diabetes and have a urinalysis performed at home.

    At home, you should follow the instructions in the test kit as they may vary. However, checking your urine ketone, protein, or glucose levels will likely require a colored bar and a look-up chart.

    You should do the test in the morning before breakfast.

    It is important to note that urine tests do not show if blood glucose levels are too low. This can be important for people who are at risk for hypoglycemia (low blood glucose).Those using insulin or other medications may need to keep their blood sugar low.

    Results

    The test results will determine the level of glucose, ketones and protein in the urine.

    Glucose

    The doctor may suggest adjusting the treatment based on the results.

    If a urine test detects glucose, the doctor will usually do a blood test for glucose and glycated hemoglobin (HbA1c) levels to determine if the person has diabetes.In controversial cases, a glucose tolerance test (GTT) may be required to detect earlier disorders of carbohydrate metabolism and to address diabetes prevention.

    If a person has high urinary glucose levels, it could be related to diabetes. If so, they will also have high blood glucose levels (hyperglycemia).

    In the short term, uncontrolled high blood sugar levels can lead to symptoms such as thirst, increased urination, and an increased risk of DKA.In the long term, this can lead to the development of micro- and macrovascular complications of diabetes mellitus – damage to the kidneys, eyes, the development of cardiovascular diseases – myocardial infarction, stroke.

    If a person is diagnosed with type 1 diabetes, they will need insulin to control their blood sugar. Type 1 diabetes usually develops during childhood or adolescence, but can occur at any time. It can also appear quickly, after a few weeks.

    Type 2 diabetes usually occurs later in life and develops over the years.A diagnosis of prediabetes will allow a person to make lifestyle changes that can slow or reverse the progression of the condition.

    The ADA recommends screening for type 2 diabetes from the age of 45 or earlier if a person has risk factors such as obesity.

    Ketones

    A person with diabetes who detects ketones in their urine should see a doctor to prevent the problem from worsening.

    If ketone levels are high, they may need hospital treatment with insulin medications, electrolytes, and fluids.

    Some low-carb diets can lead to fat breakdown and the formation of ketones for fuel. A low-carb diet does not itself cause ketoacidosis and is different from DKA.

    However, a person with diabetes should discuss their nutritional plan with their doctor and consult about any nutritional changes they wish to make.

    Proteins

    Protein in the urine can be a sign of kidney disease.

    A person with diabetes should talk to their doctor if they notice any of the following symptoms:

    • edema due to fluid retention
    • sleep problems
    • low appetite
    • weakness
    • focusing difficulty

    People with kidney disease often do not notice any symptoms until later stages, when the kidneys stop working effectively.This can lead to serious complications.

    Your doctor may suggest regular screening for urine protein, as this can help identify kidney problems in the early stages, while there is still time to take preventive measures.

    People have a higher risk of kidney disease if they have:

    • Certain genetic factors
    • persistent high blood sugar
    • high blood pressure

    Addressing high glucose and high blood pressure can reduce your risk.

    CV

    If a person finds ketones in their urine, they should see their doctor for advice. If a doctor detects high levels of glucose, ketones, or protein in a person’s urine, they may order further tests.

    Additional research may be required depending on the results.

    Oftentimes, lifestyle choices such as eating a healthy diet and exercising are key to reducing the risk of further complications.However, the doctor may also prescribe treatment or recommend hospitalization in some cases.

    Acetone test

    Diagnostic test strips are used to determine ketones (ketone bodies, acetone bodies) in urine samples.

    For self-checking.

    ✓ Minimum threshold level of detection (helps to identify Acetonemic syndrome before the appearance of a specific odor from the mouth)

    ✓ Optimal number of strips will always come in handy in your home medicine cabinet

    ✓ Maximum shelf life. Another 6 months after opening the package, you can use

    Constant monitoring of the amount of ketones in urine will help prevent the development of a severe attack of Acetonemia syndrome!

    Speed ​​of obtaining result

    You can evaluate the result in 1 minute.

    Analysis procedure

    1.Collect urine in a container

    2. Immerse the test strip in urine

    3. Wait for the result, compare with the color scale located on the container

    Why diagnose?

    During normal functioning, the body metabolizes glucose (sugar) for energy.If the cells don’t get enough glucose, the body begins to break down fats to form a large number of ketone bodies, which can be found in blood and urine.

    High levels of ketones (acetone) in urine may indicate:

    • Acetonemic Syndrome , which occurs in children predominantly from 1 to 14 years of age.
    • Diabetic ketoacidosis (DKA), a complication of diabetes that can lead to coma or even death

    Factors that contribute to an increase in the level of ketones in urine:

    • In children (overwork, colds, malnutrition, stress, excessive fatty foods)
    • In adults (diabetes mellitus, abuse of fatty and protein foods, stress, overwork)
    • In pregnant women (dehydration with toxicosis, starvation, infectious diseases, irregular intake of insulin, etc.)

    The principle and operation of the test is so simple that it is convenient to carry out both at home and in the laboratory.

    You can buy this test in the FARMASCO online store

    Download instruction for “CITOLAB K” [1216 KB]

    You may also be interested in CITO TEST® COVID-19 coronavirus infection test

    Optimal levels of ketosis and ketones

    Ketosis has many different levels, indicating the amount of ketones you are producing in your blood.Generally, the higher your ketone production level, the better your weight loss will be.

    Since blood meters are the most accurate way to measure ketones, we will use them as our main example. Generally, if you have less than 0.5 millimoles of ketones per liter of blood, you are not in ketosis.

    Here is a quick guide to ranges; optimal weight loss will be in the “deep ketosis” range:

    • Light ketosis: 0.5 mmol / L – 0.8 mmol / L
    • Medium ketosis: 0.9 mmol / L – 1.4 mmol / L
    • Deep ketosis (best for weight loss): 1.5 mmol / L – 3.0 mmol / L

    Expert opinion

    Alena Kovaleva

    Former “carbohydrate addict”, happy mom and editor-in-chief of KetoDieto.

    Ask an Expert If you are in deep ketosis ranges, you don’t need to aim for even higher levels. If the level drops to 3.0, you won’t get any better results. Sometimes, frequent high readings can indicate a lack of calories in your diet (ketosis occurs during fasting, when the body needs to break down stored energy). Don’t forget to use our keto calculator to calculate your macros.

    As a side note, it is important to mention the higher levels of ketones.Values ​​greater than 6.0 mmol / L usually indicate the onset of a dangerous condition known as ketoacidosis . While it’s nearly impossible to get to these ranges on a standard keto diet, type 1 diabetics sometimes notice it when their insulin levels are extremely low.