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Ketones urine test

Show Alternative Names
Ketone bodies - urine
Urine ketones
Ketoacidosis - urine ketones test
Diabetic ketoacidosis - urine ketones test

A ketone urine test measures the amount of ketones in the urine.

How the Test is Performed

Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketones. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones.

This article describes the ketone urine test that involves sending collected urine to a lab.

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly.

How to Prepare for the Test

You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Ketone testing is most often done if you have type 1 diabetes and:

  • Your blood sugar is higher than 240 milligrams per deciliter (mg/dL)
  • You have nausea or vomiting
  • You have pain in the abdomen

Ketone testing may also be done if:

  • You have an illness such as pneumonia, heart attack, or stroke
  • You have nausea or vomiting that does not go away especially if you take certain medicines
  • You are pregnant

Normal Results

A negative test result is normal.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

An abnormal result means you have ketones in your urine. The results are typically listed as small, moderate, or large as follows:

  • Small: <20 mg/dL
  • Moderate: 30 to 40 mg/dL
  • Large: >80 mg/dL

Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates.

This may be due to diabetic ketoacidosis (DKA). DKA is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin in relation to the amount of glucagon in the blood. Fat is used for fuel instead.

An abnormal result may also be due to:

  • Fasting or starvation: such as with anorexia (an eating disorder)
  • High protein or low carbohydrate diet
  • Vomiting over a long period (such as during early pregnancy)
  • Acute or severe illnesses, such as sepsis or burns
  • High fevers
  • The thyroid gland making too much thyroid hormone (hyperthyroidism)
  • Nursing a baby, if the mother does not eat and drink enough
  • Medicines that are sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors)

Risks

There are no risks with this test.

Review Date: 11/19/2023

Reviewed By

Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Murphy M, Srivastava R, Deans K. Diagnosis and monitoring of diabetes mellitus. In: Murphy M, Srivastava R, Deans K, eds. Clinical Biochemistry: An Illustrated Colour Text. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 32.

Sacks DB. Diabetes mellitus. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 47.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Type 1 diabetes

Type 1 diabetes

Animation

Urine sample - Illustration Thumbnail

Urine sample

A "clean-catch" urine sample is performed by collecting the sample of urine in midstream. Men or boys should wipe clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. A small amount of urine should initially fall into the toilet bowl before it is collected (this clears the urethra of contaminants). Then, in a clean container, catch about 1 to 2 ounces of urine and remove the container from the urine stream. The container is then given to the health care provider.

Illustration

 
Type 1 diabetes

Type 1 diabetes

Animation

 
Urine sample - Illustration Thumbnail

Urine sample

A "clean-catch" urine sample is performed by collecting the sample of urine in midstream. Men or boys should wipe clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. A small amount of urine should initially fall into the toilet bowl before it is collected (this clears the urethra of contaminants). Then, in a clean container, catch about 1 to 2 ounces of urine and remove the container from the urine stream. The container is then given to the health care provider.

Illustration

 
 
 

Type 1 diabetes - Animation

Your body is a fuel-burning machine, and the main fuel it burns is sugar, also known as glucose. In people who have diabetes, though, the body doesn't effectively store and use sugar for energy. As a result, sugar builds up in the blood, where it can lead to serious problems like blindness and nerve damage. Let's talk about a kind of diabetes known as type 1 diabetes.

Unlike type 2 diabetes, which is often caused by obesity, type 1 diabetes is an autoimmune disease. That means your immune system, which normally protects your body, turns against you. In this case, the immune system attacks the cells in the pancreas that produce insulin. Insulin is a hormone that moves sugar into cells. There it's stored until your body needs it for energy. Without enough insulin, sugar can't move into your cells, so it builds up in your bloodstream.

How do you know that you have Type 1 diabetes?

The first signs are usually that you feel very thirsty or tired. You may lose weight without having planned to, or feel numbness or tingling in your hands or feet. If your blood sugar has already gotten very high, your body can't use sugar for energy, so it uses fat instead. This leads to a condition called diabetic ketoacidosis. Your breath will smell fruity, like you've just eaten a fruit salad. Your breathing will get faster, and you may feel sick to your stomach.

Your doctor will test your blood sugar level to find out if you have type 1 diabetes. The test may be done when you haven't eaten anything, this is called a fasting blood glucose test.

When you have type 1 diabetes, you need to take insulin to replace what your body isn't making. Insulin is only available as an injection, so you'll have to learn how to give yourself a shot each day or wear a pump that delivers insulin to your body continuously.

Managing diabetes also means watching your diet so you don't get too much or too little sugar at once. You also need to check your blood sugar levels regularly, and keep track of them over time.

Type 1 diabetes is a lifelong disease, but it's one you can control, and live with. The key to staying healthy with diabetes is partnering with your team of doctors. Test your blood sugar at home, and have your doctor check your A1c levels at least every 3 to 6 months. This test shows how well you're controlling your blood sugar over time.

Also visit your doctor for regular cholesterol, blood pressure, and kidney tests. See an eye doctor at least once a year, and a dentist every 6 months. Also check your feet every day for skin sores that you might not be able to feel because of nerve damage. And see a podiatrist or your regular doctor for a foot exam twice a year. If you're having any symptoms like fatigue, frequent urination, blurred vision, foot sores, numbness or tingling, or a fast heartbeat, call your doctor right away.

 

Type 1 diabetes - Animation

Your body is a fuel-burning machine, and the main fuel it burns is sugar, also known as glucose. In people who have diabetes, though, the body doesn't effectively store and use sugar for energy. As a result, sugar builds up in the blood, where it can lead to serious problems like blindness and nerve damage. Let's talk about a kind of diabetes known as type 1 diabetes.

Unlike type 2 diabetes, which is often caused by obesity, type 1 diabetes is an autoimmune disease. That means your immune system, which normally protects your body, turns against you. In this case, the immune system attacks the cells in the pancreas that produce insulin. Insulin is a hormone that moves sugar into cells. There it's stored until your body needs it for energy. Without enough insulin, sugar can't move into your cells, so it builds up in your bloodstream.

How do you know that you have Type 1 diabetes?

The first signs are usually that you feel very thirsty or tired. You may lose weight without having planned to, or feel numbness or tingling in your hands or feet. If your blood sugar has already gotten very high, your body can't use sugar for energy, so it uses fat instead. This leads to a condition called diabetic ketoacidosis. Your breath will smell fruity, like you've just eaten a fruit salad. Your breathing will get faster, and you may feel sick to your stomach.

Your doctor will test your blood sugar level to find out if you have type 1 diabetes. The test may be done when you haven't eaten anything, this is called a fasting blood glucose test.

When you have type 1 diabetes, you need to take insulin to replace what your body isn't making. Insulin is only available as an injection, so you'll have to learn how to give yourself a shot each day or wear a pump that delivers insulin to your body continuously.

Managing diabetes also means watching your diet so you don't get too much or too little sugar at once. You also need to check your blood sugar levels regularly, and keep track of them over time.

Type 1 diabetes is a lifelong disease, but it's one you can control, and live with. The key to staying healthy with diabetes is partnering with your team of doctors. Test your blood sugar at home, and have your doctor check your A1c levels at least every 3 to 6 months. This test shows how well you're controlling your blood sugar over time.

Also visit your doctor for regular cholesterol, blood pressure, and kidney tests. See an eye doctor at least once a year, and a dentist every 6 months. Also check your feet every day for skin sores that you might not be able to feel because of nerve damage. And see a podiatrist or your regular doctor for a foot exam twice a year. If you're having any symptoms like fatigue, frequent urination, blurred vision, foot sores, numbness or tingling, or a fast heartbeat, call your doctor right away.

 
 
 
 

 

 
 
 
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