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Diabetes and Urine Tests

How Do I Test for Ketones?

Testing for ketones involves dipping a test strip into your urine. The test strip changes color and is then compared to a color chart.

When Should I Test for Ketones?

If you have type 1 diabetes, you may need to check your urine for ketones if:

  • You feel sick (have a cold, the flu, or other illness) and have nausea or vomiting.
  • You are pregnant.
  • Your blood sugar level is high (usually over 300 milligrams per deciliter or mg/dL) or as directed by your doctor.
  • You have symptoms of high blood sugar including extreme thirst or tiredness, a flushed or foggy feeling, or your breath smells fruity.

If you have type 2 diabetes, you have a very low chance of developing ketoacidosis, even if you are on insulin therapy. However, during severe illnesses, it is possible that ketoacidosis may develop.

If you have type 2 diabetes, your doctor may advise you to check your urine for ketones when:

  • You feel severely sick (have a cold, the flu, or other illness) and/or have unexplained nausea or vomiting
  • Your blood sugar level is high (over 300 milligrams per deciliter or mg/dL, or as directed by your doctor) and continues to rise throughout the day.


When Should I Call My Doctor?

The result of the urine test for ketones should always be negative. Any positive results should be reported to your health care provider immediately. You should also call your doctor right away if your blood sugar remains elevated or if you have stomach pain, nausea, vomiting, rapid breathing, sweet-smelling breath, or if you are urinating excessively.

After contacting your doctor, you should follow his or her instructions which may include:

  • Drink plenty of water and fluids to try to decrease the amounts of ketones and maintain hydration.
  • Continue to check your blood sugars intermittently; they may be high and you may need to give yourself a small amount of very rapid acting insulin. Your health care provider will give you instructions on what to do.
  • Go to the local emergency room if instructed by your doctor to receive intravenous fluid and insulin therapy.

How Do I Record My Urine Test Results?

Keep detailed records of any urine or ketone tests you perform. Your records can help alert you and your health care provider to any problems. Bring these records with you every time you visit your health care provider.

Get information on how to manage diabetes every day.
Learn about hemoglobin A1C, an important blood test for people with diabetes.
View the full table of contents for the Diabetes Guide.


WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on July 11, 2014

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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