How to Test Ketones For Diabetes

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By : dLife Editors

If you live with diabetes, then there is no doubt that you know how crucial it is to check your blood on a regular basis.  But you should also keep an eye on ketones, particularly if you have type 1 or advanced type 2 diabetes and you use insulin.

The need for ketone testing is not often communicated to people with diabetes or may be restricted to individuals with type 1 diabetes only.

However, testing ketones for diabetes are highly essential and should be part of every individual looking to effectively manage diabetes. The test is relatively simple and it is important you know about it if you have diabetes.

What exactly are Ketones?

Ketones are organic chemicals that build up and accumulate when your body begins to burn fat for energy instead of carbohydrate and sugars. This often occurs in diabetics as a result of insulin deficiency.

When insulin is not enough in the body, glucose will find it difficult to enter into cells and so build up in the bloodstream. The cells will then have to turn to an alternative; burning fat for energy instead of glucose.

This will increase the concentration of ketones in the blood and eventually spill into the urine.

Ketones could be a sign that your body is deficient in insulin and could result in a condition known as Diabetic Ketoacidosis (DKA).

Therefore, it is important diabetics regularly keep an eye on their insulin level to ensure they are not falling short. Some common signs of DKA could include moderate to large ketones, vomiting, nausea, fruity breath, abdominal pain, rapid breathing, and lack of energy.

When DKA is left untreated could lead to serious and life-threatening issues in diabetics, including coma or death.

Ketones can also be present even in the blood with normal blood sugar levels. A condition usually called “nutritional ketones” or “starvation ketones.”

These happen during illness or extreme diet change like people on ketogenesis diet where there is an intense decrease in carbohydrate consumption to promote fat loss.

 How Do I Test for Ketones?

Your diabetes educator or doctor is in the best position to discuss how to test for ketones, whether you have type 1 or type 2 diabetes.

Most people living with type 2 diabetes, however, may not necessarily need to check for this organic compound since diabetic ketoacidosis (DKA) is less common or rare in this category.

But find out from your doctor or diabetes educator whether or not it is necessary for you to test for ketones, especially if you are on long-acting and fast-acting (at mealtime) insulin.

Ways to test ketone levels:

#1: Using Blood Ketone Meter

Some blood glucose meters can measure ketones in the blood and requires the use of ketone test strips as against blood glucose test strips. The user manual of the meter has some instructions that you can follow to test for ketones in your blood as well as how to determine the results.

#2: Using Urine Ketone Strips

Testing for ketones is done more frequently using urine ketone strips. You can buy a box or bottle of ketone strips over the counter (without a prescription) at your local pharmacy.

The strips are user-friendly and you can follow the instructions on how to use them as indicated on the package.

Results can be negative, show trace, small, moderate or large amounts of the organic compound. If you there is moderate to large amounts of ketones in your urine, please inform your doctor.

#3: Breathe Testing

This is a cheaper and non-invasive alternative when it comes to measuring ketones through the levels of acetone in the breath.

This method has been proved in some studies to be a great way to test for nutritional ketosis. However, this method may not always be a pure reflection of ketones in the blood because they can be affected by some other factors like water intake and alcohol consumption.

When Should You Test For Ketones?

It is an excellent idea to test for ketones when:

  • Your blood sugar is above 250 for two checks in succession
  • You have plans of engaging in workouts and your blood sugar is greater than 250
  • You have an infection, injury or feel sick
  • You are pregnant. You should carry out the test every morning before meals and when blood sugar is more than 250


Bottom Line

It is important to regularly test your ketone levels as this is a key part of type 1 diabetes management. It could help prevent a dangerous short-term complication like ketoacidosis.

Therefore, if you have type 1 diabetes, it is important and recommended that your prescription have ketone-testing supplies on it.

Ketone testing may also be of great use for people living with other types of diabetes that are dependent on insulin.


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3. American Diabetes Association. DKA (Ketoacidosis) & Ketones. Retrieved from

4. University College London Hospitals. Ketones and Diabetic ketoacidosis (DKA). NHS Foundation. Retrieved from

5. Kyla Schmieg. (2017). Ketones — The 6 Must-Knows. Beyond Type 1. Retrieved from

6. Musa-Veloso, K., Likhodii, S. S., Cunnane, S. C. (July 2002). Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. The American Journal of Clinical Nutrition. Retrieved from