Ketones in Urine: Signs, Tests, And Results

Ketones in Urine

Ketones in Urine 

ketones in urine

Ketones are the chemical by-products of your body. They produce when the insulin level in your body decreases and it is unable to turn glucose into energy. A human liver processes the functioning of insulin in your body when the fat breaks down. People with diabetes must keep an eye on their ketone levels. It is mostly produced overnight. When people with type 1 diabetes stop taking insulin, the ketone level in their bodies increases. Ketone produced in the human body tries to pass out. However, we leave them untreated, ketones in urine can poison your entire body. There are higher chances of your body developing diabetic ketoacidosis. Although, ketones are not really dangerous for people without diabetes, but can be life-threatening to people with diabetes. 

Diabetic Ketoacidosis

Diabetic ketoacidosis

Diabetic Ketoacidosis is a severe condition of the human body that can lead to diabetic coma or even death. This happens when ketones produced in your body from breaking down of body fat increase their number quickly. This happens when the human body lacks the amount of glucose. At this moment, it becomes important for the body to break down the fats to generate energy. However, higher levels of ketone are rare in people with type 2 diabetes.

Difference Between Ketosis and Ketoacidosis

Ketosis and Ketoacidosis

Similar to ketoacidosis, ketosis also develops when the body produces ketones but ketosis is not harmful. When the body produces a high amount of ketosis in the body but doesn’t get acidic, we call the condition ketosis. It can happen to a person who is on a low carbs diet or someone who has consumed too much alcohol. A human body is diagnosed with ketosis if the level of ketones in its body is more than 1.5mmol/L. This is the initial stage of the human body to start relying upon body fat to generate energy instead of glucose from your blood cells.

Ketoacidosis, on the other hand, is harmful and can even cause coma or death. In ketoacidosis, the human body produces dangerously high levels of ketones in urine, hence making the entire body acidic. It eventually leads to higher risks of diabetic coma or even death. The death rate for ketoacidosis is about 2 to 5 percent. People of or under the age of 30 make up to 36 percent of total people dead due to ketoacidosis. People between the ages of 31-50 make up 27 percent, 23 percent are between the ages of 51-70 and 14 percent are over the age of 70.

Signs Of Ketoacidosis


When a person develops ketosis, it is not a dangerous medical condition but if we leave it untreated for a longer time, there is a higher risk of you developing ketoacidosis. A person can know if he is diagnosed with ketoacidosis under the following circumstances:

  1. Trouble breathing 
  2. Nausea
  3. Vomiting
  4. Unusual thirst
  5. Confusion
  6. Breath smelling fruity
  7. Flushed skin
  8. Unconsciousness
  9. Sleepiness

The above mentioned are the signs of ketoacidosis. if you are experiencing 3 or more than 3 signs, it is advised to consult a doctor and get yourself tested.

Steps Involved In Ketone In Urine Test

steps of ketone in urine test

We can do a ketone in urine test either at home or at a lab. At a lab, we can perform a ketone in urine test in the following steps:

  1. Wash your hands.
  2. Clean your genital area. One can use a cleansing pad.
  3. Collect the catch sample in the container. There is a mark on the container and you have to collect the same amount of samples as instructed by your healthcare provider. 
  4. Submit your sample in the lab.

At home, the person can get a ketone in the urine test kit and follow the instructions provided on them. Mostly, the kits have strips in them and the patient can pee directly on the stick and find out the results.

A urine test for checking the level of ketones in the urine can be done two ways:

  1. Urine glucose test

The urine glucose test is a very simple and quick way of checking ketone levels. The lab assistant will collect a sample of your urine in the same way mentioned above and then a device called a dipstick will measure the amount of glucose in your blood. 

  1. Urinalysis 

Urinalysis is the most accurate way of measuring the level of ketones in the urine. When blood travels through your body, your kidney filter outs the blood and emits the ketones as a waste. Urinalysis gives similar results. 

Reliability Of Ketone Urine Test Strips 

Ketone Urine Test Strips 

Although Ketone urine test strips are reliable, there are chances of inappropriate results which may lead you to take other actions. This may happen due to the following reasons:

  1. If you have taken any medicine before the test.
  2. If you have taken any kind of vitamin or herb before the test.
  3. In the cases of dehydration.

These situations make the results fluctuate a bit. You can reach out to a doctor for further proceedings.

If there is a delay in the results, it may cause fluctuations in the figures. This eventually arises the following situations:

  1. The ketone level increases immediately, so there is a possibility that the result may have come late and in between the time of the test done and the test result, the ketone level must have increased.
  2. It is also possible that the ketones may have passed through your body a few hours before the test is done even though the level of ketones may have already started falling.
  3. The test can also be false, in case of higher levels of beta-hydroxybutyrate, since the test detects acetoacetate instead of the beta-hydroxybutyrate, which is the main ketone.

Therefore, you must be aware of all the reasons which may cause a difference in the results. 

Blood Tests For Ketones In Urine

Blood tests for ketones in urine

Blood tests are also done to test the number of ketones in the urine. It can also be done either at a doctor’s office or at home. The doctor collects the blood sample with the help of a thin needle. He inserts it into a nerve of your arm and then collects the required amount of blood sample. 

For performing the test at home, 

  1. Insert one blood ketone strip into the meter.
  2. Wash your hands with water and soap properly. 
  3. Using the lancing device, stick your finger.
  4. Put a drop of the blood on the hole of the strip
  5. Check the results displayed on the meter. 

Follow these steps to take a test at home or at a doctor’s clinic and consult your doctor along with the reports.

Breath testing for ketone in urine

breath tests for ketones in urine

Testing the level of ketones by breath testing is another way that is more convenient than the other ways mentioned above. Acetone, β -hydroxybutyric acid, and acetoacetic acid are three varied varieties of ketones that may be found in the breath, blood, and urine. Detecting altered concentrations of ketones in the breath, blood, and urine is important for the diagnosis and treatment of diabetic ketosis. However, people still go for urine or blood tests as they are more concrete and reliable ways to get yourself tested.

Level of Ketones in Urine

The moderate amount of ketones in the human body should be less than 0.6 millimoles per litre (mmol/L). Although a person needs to seek immediate medical help if the ketone level goes beyond that.

Moderate levelLess than 0.6 mmol/L
Low to moderate0.6-1.5 mmol/L
High1.6-3.0 mmol/L
Very high More than 3.0 mmol/L

A person should consult a doctor right away if the ketone level in his diagnosis results lies anywhere between low to moderate and very high level.

What can affect the results of the Ketones In Urine Test?

Following a special diet, heavy exercising, or intake of certain medicines can affect the results of the test. It is advised to ask your healthcare provider if you should be avoiding any medication or specific food before going for the test. 

One should take a ketone in a urine test if they have a high fasting sugar level. The person going to get tested must be fasting. Also, it is important that you take advice from your doctor. You should contact him before going for the test. Make sure that he is aware of all the medications you are taking, legal or illegal, and all the medications that your body rejects. He must have your full medical history to get better results. 

Results of Ketones In Urine Test

Results of Ketones In Urine Test

The moderate level of ketone should be under 0.6 mmol/L. Although if your test results show a slight increase in the level, that means your body has started using fat to generate energy and you have ketosis or you must have missed a dose of insulin. You should ask your doctor how much more insulin your body requires. However, if your test results show high or very high levels of ketones, you must immediately consult your healthcare provider. 

When should one take a ketone in urine test?

when to take a test

For the diagnosis of ketone in urine, there is a test called urine glucose test or a part of urinalysis is performed. The test is performed to monitor the level of ketones in the urine of a human body. This is usually found in people with type 1 diabetes or type 2 diabetes and otherwise in people with the following symptoms:

  1. Frequent urination
  2. Dry mouth
  3. Blood sugar level higher than 240mg/dl
  4. Vomiting
  5. Diabetes
  6. Pregnancy
  7. Eating disorder
  8. Pneumonia
  9. High fever
  10. Burns 
  11. Infection
  12. Fasting
  13. Nursing without a proper diet

If you are experiencing any of the symptoms mentioned above, you should immediately take a test and consult your healthcare advisor. 


The above article explains the effects of ketones in the urine and the ways to diagnose them. The article also includes the symptoms and entire procedure of the test for ketone levels in the urine of a human body. 

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