From the Guidelines
Ketones in urine indicate a serious condition, especially for people with diabetes, and require immediate medical attention to prevent diabetic ketoacidosis (DKA) and other complications. This occurs when there's insufficient insulin to help cells use glucose, forcing the body to burn fat and produce ketones as an alternative fuel source 1. For diabetic patients, ketonuria often signals DKA, a potentially life-threatening condition that requires immediate medical attention.
Key Points to Consider
- If you have diabetes and detect ketones in your urine, you should contact your healthcare provider right away, increase your fluid intake with sugar-free beverages, check your blood glucose levels frequently, and administer insulin as directed by your doctor 1.
- The presence of ketones can be detected using urine test strips available at pharmacies.
- For people with type 1 diabetes, testing for ketones is recommended when blood glucose exceeds 240 mg/dL, during illness or stress, or when experiencing symptoms like nausea, vomiting, or abdominal pain 1.
- Regular monitoring of ketones, especially during illness or when blood glucose is elevated, is an essential part of diabetes management to prevent the development of DKA.
Recommendations for Ketone Testing
- Individuals who are prone to ketosis (those with type 1 diabetes, history of diabetic ketoacidosis [DKA], or treated with sodium–glucose cotransporter 2 [SGLT2] inhibitors) should measure ketones in urine or blood if they have unexplained hyperglycemia or symptoms of ketosis (abdominal pain, nausea) and implement sick-day rules and/or seek medical advice if urine or blood ketones are increased 1.
- Specific measurement of b-hydroxybutyrate in blood should be used for diagnosis of DKA and may be used for monitoring during treatment of DKA 1.
Importance of Early Detection and Treatment
Early detection and treatment of ketonuria are crucial to prevent the development of DKA and other complications, and individuals with diabetes should be educated on the importance of regular ketone monitoring, especially during illness or when blood glucose is elevated 1.
From the FDA Drug Label
Early signs of diabetic ketoacidosis include glycosuria and ketonuria Polydipsia, polyuria, loss of appetite, fatigue, dry skin, abdominal pain, nausea and vomiting and compensatory tachypnea come on gradually, usually over a period of some hours or days, in conjunction with hyperglycemia and ketonemia. When you are sick, test your blood glucose frequently If instructed by your doctor, test your ketones and report the results to your doctor.
Ketones in Urine: The presence of ketones in urine, also known as ketonuria, is a sign of diabetic ketoacidosis (DKA), a serious complication of diabetes. DKA occurs when the body produces high levels of ketones, which are acidic substances that can poison the body.
- Causes: Ketonuria can be caused by a lack of insulin, which can occur in people with type 1 or type 2 diabetes.
- Symptoms: The symptoms of DKA include polydipsia, polyuria, loss of appetite, fatigue, dry skin, abdominal pain, nausea, and vomiting.
- Implications: If left untreated, DKA can lead to serious health problems, including coma and death.
- Monitoring: People with diabetes should monitor their blood glucose levels and ketone levels regularly, especially when they are sick.
- Treatment: Treatment for DKA typically involves administering insulin and fluids to help the body recover. 2
From the Research
Ketones in Urine
- Ketones in urine are a sign of the body breaking down fat for energy instead of glucose, which can be a concern for patients with diabetes [ 3 ].
- In patients with diabetes, the presence of ketones in urine can indicate diabetic ketoacidosis, a serious complication that requires immediate medical attention [ 3 ].
- Diabetic ketoacidosis occurs when the body produces high levels of ketones, which can lead to a range of symptoms including nausea, vomiting, and abdominal pain [ 3 ].
Implications for Patients with Diabetes
- For patients with diabetes, having ketones in urine can be a sign that their blood sugar levels are not well-controlled [ 4 ].
- Studies have shown that rapid-acting insulin analogs such as aspart and lispro can help to correct abnormalities in carbohydrate and fat metabolism in patients with type 1 diabetes [ 4 ].
- However, the presence of ketones in urine can also be a sign of other underlying health issues, and patients with diabetes should consult with their healthcare provider to determine the best course of treatment [ 3 ].
Detection and Treatment
- Ketones in urine can be detected using a simple urine test strip [ 3 ].
- Treatment for diabetic ketoacidosis typically involves administering insulin and fluids to help the body replenish lost fluids and electrolytes [ 3 ].
- In some cases, patients may need to be hospitalized to receive treatment and close monitoring [ 3 ].