Ketone Testing

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KEY POINTS

• Ketone testing uses samples of blood or urine to measure ketones, which are chemicals the body makes when it burns fat instead of glucose (sugar) for energy. When ketones build up to dangerous levels, this can cause coma or death if not treated right away.
• You can do the tests at home with kits bought at the drugstore. The blood ketone test tells you what the ketone level is at the moment you do the test. The urine ketone test shows what the ketone level was a few hours earlier.
• Follow your child’s healthcare provider’s recommendations for reporting urine or blood ketone test results.

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What is ketone testing?

Ketone testing uses samples of blood or urine to measure ketones, which are chemicals the body makes when your body burns fat for energy.

If the body does not make enough insulin, glucose (sugar) cannot move out of your child’s blood and into the cells. Your child’s blood glucose can get very high and the body burns fat instead of glucose for energy. This makes byproducts called ketones. When ketones build up to dangerous levels, it is called ketoacidosis. This can cause coma or death if not treated right away. Ketoacidosis may happen with type 1 diabetes. It rarely happens with type 2 diabetes.

Why is it done?

Your provider may recommend that you check for ketones if:

• Your child’s blood glucose level is higher than your healthcare provider recommends.
• Your child is sick or under more stress than usual. If a child is sick, ketones can be present even when blood glucose level is not high.

How do I prepare for this test?

You can do the tests at home with kits bought at the drugstore. You can test the urine or blood for ketones. The blood ketone measurement tells you what the ketone level is at the moment you do the test. The urine ketone test shows what the ketone level was a few hours earlier.

Make sure you have a ketone test kit available to use at all times in case your child gets sick or has had recent changes in medicines.

How is the test done?

Urine Tests

You can use urine test strips to check for ketones in urine. Ask your pharmacist about the types of urine ketone strips that are available.

Carefully follow the package directions for testing. Urine ketone tests must be timed exactly using a watch or clock with a secondhand. After you dip the strip in the urine sample, compare the color of the test strip with the colors in the chart on the container to see how high your ketones are. Ask someone else to watch the timing of the test with you and to check your reading of the strip. This helps prevent errors.

If your child is not yet toilet trained, it is usually best to press a test strip firmly against a wet diaper. Or you can put a cotton ball in the diaper near the place where your baby urinates. Drops of urine can then be squeezed from the cotton ball onto a test strip.

Blood Tests

To check for ketones in the blood you need a meter and blood ketone strips. Your healthcare provider can show you how to use the meter.

What does the test result mean?

Some of the reasons ketones may be higher than normal are:

• Your child’s blood glucose is too high.
• There is too little carbohydrate (starch) in your child’s diet.
• Your child has gone too long without eating.

Urine ketone test results can be affected by some medicines. Make sure your healthcare provider knows about all of the medicines your child takes.

Follow your healthcare provider’s recommendations for reporting urine or blood ketone test results. This is a very important part of getting your child’s diabetes under control.

What if my child’s test result is not normal?

If your child has diabetes and is sick, and the urine test shows trace amounts of ketones, ketones may be starting to build up. Follow your child’s sick day plan and your healthcare provider’s instructions.

If the urine test shows moderate or high levels of ketones, even if your child is not sick, call your child’s healthcare provider right away (day or night). Ketones may build up to dangerous levels.

Do not have your child exercise if the blood glucose level is over 250 mg/dl and ketones are present.

Test results are only one part of a larger picture that takes into account your child’s medical history and current health. Sometimes a test needs to be repeated to check the first result. Talk to your healthcare provider about ketone tests and ask questions, such as:

• If your child needs more tests
• What kind of treatment your child might need
• What lifestyle, diet, or other changes you might need to make