When people with diabetes – type 1 or 2 – are under a great deal of stress or illness, extra energy is needed to help combat the situation and sugar cannot be utilized due to the lack of insulin. The body turns to fat as an energy source, and a toxic byproduct of fat breakdown called ketones is formed. Ketones circulate in the system as acids and change the PH of the blood; this can be a life threatening complication of diabetes called DKA (Diabetic Ketoacidosis).

When blood sugars are over 240mg/dl during times of illness, infection, or severe stress, you should test for ketones. In addition to these conditions listed above, this could also happen to people who miss their insulin doses, have a malfunctioning insulin pump, have used expired or improperly stored insulin, as well as in pregnancy with diabetes.

Ketone testing through urinalysis has been available for over thirty years, with blood ketone testing being a more recent and approved technology.

Here are a few reasons to test for ketones:

  1. Blood testing is more convenient than urine testing.
  2. Urine testing can be inaccurate due to volume and concentration of the urine.
  3. Urine testing strips that are exposed to air or have been opened in a bottle for 90 days can be inaccurate (foil wrapped strips last longer).
  4. Excess Vitamin C or ascorbic acid in the system can give a false positive for ketones due to the acid content on urine strips.
  5. At home blood ketone testing can result in lower emergency room costs, hospitalizations, and help prevent DKA.
  6. Blood ketone testing can test for a type of ketone that cannot be detected in urine which could lead to a false negative in the urine test.
  7. Ketones are detectable in the blood faster than in the urine.

NOTE: Consult your doctor first to make sure my recommendations fit your special health needs.

Roberta Kleinman

Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia.

She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.

She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
Roberta Kleinman