What Are Ketones, And Why Are They Important To Diabetes Self-management?
All blood tests are tools. Some are to diagnose diabetes, some are to help you manage your diabetes on a daily or long term basis and some are to keep you safe. People with diabetes are told about blood testing and how important testing is to manage their blood glucose. It is a critical part of diabetes management. Whether it is done in the physician’s office or the patient’s home it is an invaluable tool, Unfortunately a very important test, ketone testing is often not taught or taught only to people with type 1 diabetes. This test can be life saving and should be part of every person with diabetes knowledge and skills. It is simple and if you have diabetes you should know about it. What Are Ketones? When the body is unable to burn glucose it burns fat and this produces a chemical called ketones. This occurs when there is too little insulin for the amount of glucose in the body. Possible causes for this could be: Experiencing stress or illness such as fever, Having an infection. Omitting or taking too little insulin Eating more food than planned Improper storage of insulin If left untreated, ketones continue to rise and can result in a condition called Diabetic Ketoacidosis, or DKA. This condition is quite serious and requires immediate medical attention. DKA is the most common cause of hospitalization and death among children and young adults with diabetes, and the leading cause of adverse events for insulin pump users. Why Measure Blood Ketones? Studies suggest that most, if not all emergency department and hospital admissions beyond initial diabetes diagnosis could be prevented if people better managed their diabetes care and knew the warning signs when ketoacidosis was developing. Blood ketone testing provides a rapid, accurate, and early warning sign that keto Continue reading >>
Urine Tests For Diabetes: Glucose Levels And Ketones
The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>
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Ketones In Urine: What Are Ketones & How Does Ketosis Affect Diabetes?
All the news about the ketogenic diet makes it seem like a good idea to achieve nutritional ketosiswhen your body burns through all the carbs youve stored and begins breaking down fat for energy. And while the jury is out on how effective that diet is for weight loss , nutritional ketosis is typically not dangerous. However, for people living with diabetes, ketoacidosis can be life-threatening. When you eat a very low-carb diet, do a period of prolonged exercise, or go for a long period of time without eating, there is some increase in the level of ketones in the body, but it's not necessarily dangerous because the ketones are at a low to moderate level, explains Rekha Kumar, MD, endocrinologist at New York-Presbyterian/Weill Cornell Medical Center. But people with type 1 diabetes who don't make enough insulin can reach very high levels of ketones, which can cause the blood to have acid in it. Not everyone with diabetes needs to monitor their ketone levels, but knowing what ketones are and when you should check can help you manage your diabetes. Ketones are a breakdown product of fat. Normally carbsin the form of glucoseare the body's primary source of fuel, but when you don't have enough glucose, the body turns to fat for energy. As the body oxidizes fat, ketones are produced in the liver. Although this can happen when someone doesn't eat enough carbs (as on the keto diet ), it also happens when the body doesn't produce insulin, as with type 1 diabetes. If you don't have enough insulin in your blood, the body thinks it's in a state of starvation, explains Nestoras Nicolas Mathioudakis, MD, clinical director of the division of endocrinology, diabetes, and metabolism at Johns Hopkins School of Medicine. Sugar levels will rise in the blood, but without insulin, it can't Continue reading >>
Ketones In Urine
What is a Ketones in Urine Test? The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don't get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs. Other names: ketones urine test, ketone test, urine ketones, ketone bodies What is it used for? The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don't have diabetes, you may still be at risk for developing ketones if you: Participate in strenuous exercise Are on a very low-carbohydrate diet Are pregnant Why do I need a ketones in urine test? Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include: People with type 1 diabetes are at a higher risk for ketoacidosis. What happens during a ketones in urine test? A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a "clean catch" sample. The clean catch method generally includes the following steps: Wash your hands. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back. Start to urinate into the toilet. Move the collect Continue reading >>
Five Things To Know About Ketones
If you live with diabetes, you have probably heard that ketones are something to watch out for. That they have something to do with the dreaded diabetic ketoacidosis (DKA). But do you really understand what ketones are and why they happen? It’s scary to think about, sure. But it’s also very important to be in the know about ketones and to be prepared. 1) What are ketones? If there isn’t enough insulin in your system, you can’t turn glucose into energy. So your body starts breaking down body fat. Ketones are a chemical by-product of this process. This can occur when people with type 1 diabetes don’t take insulin for long periods of time, when insulin pumps fail to deliver insulin and the wearer does not monitor blood glucose, or during serious illness (in type 1 or type 2) when insulin doses are missed or not increased appropriately for the stress of illness. Ketones can happen to anyone with diabetes, but the condition is more common in people with type 1. 2) Why are ketones dangerous? Ketones upset the chemical balance of your blood and, if left untreated, can poison the body. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Eventually they build up in the blood. The presence of ketones could be a sign that you are experiencing, or will soon develop, diabetic ketoacidosis (DKA)—a life-threatening medical emergency. 3) When should I test for ketones, and how? There are several situations in which it is a good idea to check for ketones, usually every four to six hours. Talk to your doctor to know what makes the most sense for you and your diabetes management plan. Your blood glucose is more than 300 mg/dl (or a level recommended by your doctor) You feel nauseated, are vomiting or have abdominal pain You are Continue reading >>
Ketones — The 6 Must-knows
WRITTEN BY: Kyla Schmieg, BSN, RN Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and Type 1 Diabetic, working on the same unit she was diagnosed at 26 years ago. 1 – What are ketones? Ketones are chemicals that build up when your body starts to burn fat for energy. The most common cause of ketones in diabetics is insulin deficiency. Without enough insulin, glucose builds up in the blood stream and can’t enter cells. The cells then burn fat instead of glucose. This results in ketones forming in the blood and eventually spilling into urine. 2 – Why can ketones be dangerous? Having ketones can indicate that your body needs more insulin. (Always monitor your blood sugar levels to know how much insulin you need.) If you have a build up of ketones, this can lead to Diabetic Ketoacidosis (DKA). Signs of DKA include moderate or large ketones, nausea, vomiting, abdominal pain, fruity or acetone (think nail polish remover) breath, rapid breathing, flushed skin, and lack of energy. If left untreated, it can lead to a serious and life-threatening diabetic coma or death. High levels of ketones are toxic to the body and if you’re experiencing these, you should seek out medical attention. 3 – When should you check for ketones? You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold. 4 – Can you get ketones with a high blood sugar? Ketones typically accompany high blood sugar. They indicate that your body needs more insulin. Most often if your body needs more insulin, it means you probably have a high blood sugar. Also, when an illness is present, your body releases hormones in response to the stress. These hormones Continue reading >>
Diabetes And Ketones
Tweet The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis. Ketones build up when there is insufficient insulin to help fuel the body’s cells. High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes. If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible. What are ketones? Ketones are an acid remaining when the body burns its own fat. When the body has insufficient insulin, it cannot get glucose from the blood into the body's cells to use as energy and will instead begin to burn fat. The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy. It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned. In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis. How do I test for ketones? Ketone testing can be carried out at home. The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels. You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago. Read about testing for ketones and how to interpret the results Who needs to be aware of ketones? The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis: Anyone dependent on insulin – such as all people Continue reading >>
What Are Ketones And Their Tests?
A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>
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Type 1 Diabetes - Ketones Diabetes New Zealand
Ketones are very easy to test for. When your body is high in ketones, it tries to get rid of them very quickly. It does this by pushing them out in your urine.Testing your urine for ketones will give you a clear indication of how high your blood ketones are. You develop ketones if you are not having enough insulin. Your insulin needs will change in certain situations. When you are sick or injured, your body becomes resistant to the action of insulin (your insulin cant work properly) and your bodys need for energy increases. This is because your body needs extra energy to fight infection or heal from an injury. So to put it simply, having ketones means your body needs more insulin. You should test for ketones either when your blood glucose is more than 17mmol/L OR if your blood glucose is climbing and you feel unwell, OR if you are injured and your ketone levels are increasing. That depends on what sort of ketone testing strips you have. At the moment ketone testing that you do at home is always done on your urine. At what level of ketones in my urine should I be concerned? A trace to a small amount of ketones in your urine is usually okay. However, if you are showing small amounts of ketones and you are unwell you should keep a careful eye on whether they are increasing or coming down. Get help if they continue to increase. If you are showing a moderate or large amount of ketones in your urine you need to act quickly to bring them down. You should ALWAYS contact your doctor or diabetes nurse educator if you have a moderate or large amount of ketones in your urine. If you cant get immediate advice, you should go to the nearest hospital. If your ketones are high and you are feeling unwell this trip to the hospital should be in an ambulance. Other things you can do for yo Continue reading >>
What Is Diabetic Ketoacidosis?
Diabetic ketoacidosis is a serious condition characterized by high blood sugar (hyperglycemia), low insulin, and the presence of moderate to large amounts of ketones in the blood. It's a medical emergency that requires treatment in a hospital. If not treated in a timely fashion, ketoacidosis can lead to coma and death. While diabetic ketoacidosis (or DKA) is much more common among people with type 1 diabetes, it can also occur in people with type 2 diabetes, so ketone monitoring is something everyone with diabetes should understand. Diabetic Ketoacidosis Symptoms Signs and symptoms of ketoacidosis include: Thirst or a very dry mouth Frequent urination Fatigue and weakness Nausea Vomiting Dry or flushed skin Abdominal pain Deep breathing A fruity breath odor What Are Ketones? Ketones, or ketone bodies, are acidic byproducts of fat metabolism. It's normal for everyone to have a small amount of ketones in the bloodstream, and after a fast of 12 to16 hours, there may be detectable amounts in the urine. As is the case with glucose, if blood levels of ketones get too high, they spill over into the urine. An elevated level of ketones in the blood is known as ketosis. People who follow low-carbohydrate diets often speak of ketosis as a desirable state — it's evidence that their bodies are burning fat, not carbohydrate. But the level of ketosis that results from low carbohydrate consumption isn't harmful and is much lower than the level seen in diabetic ketoacidosis. When Should Ketones Be Monitored? Ketone monitoring is less of a concern for people with type 2 diabetes than for those with type 1 diabetes. This is because most people with type 2 diabetes still make some of their own insulin, making diabetic ketoacidosis less likely to develop. Nonetheless, people with type 2 d Continue reading >>
How Dka Happens And What To Do About It
Certified Diabetes Educator Gary Scheiner offers an overview of diabetic ketoacidosis. (excerpted from Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin by Gary Scheiner MS, CDE, DaCapo Press, 2011) Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you. The primary cause of DKA is a lack of working insulin in the body. Most of the body’s cells burn primarily sugar (glucose) for energy. Many cells also burn fat, but in much smaller amounts. Glucose happens to be a very “clean” form of energy—there are virtually no waste products left over when you burn it up. Fat, on the other hand, is a “dirty” source of energy. When fat is burned, there are waste products produced. These waste products are called “ketones.” Ketones are acid molecules that can pollute the bloodstream and affect the body’s delicate pH balance if produced in large quantities. Luckily, we don’t tend to burn huge amounts of fat at one time, and the ketones that are produced can be broken down during the process of glucose metabolism. Glucose and ketones can “jump into the fire” together. It is important to have an ample supply of glucose in the body’s cells. That requires two things: sugar (glucose) in the bloodstream, and insulin to shuttle the sugar into the cells. A number of things would start to go wrong if you have no insulin in the bloodstream: Without insulin, glucose cannot get into the body’s cells. As a result, the cells begin burning large amounts of fat for energy. This, of course, Continue reading >>
Ketones And Children With Type 1 Diabetes – What’s Important?
What are ketones and when do you check for them in children with type one diabetes? This is a common question I get! I think when children are diagnosed, this a frequent part of the education that is easily forgotten or misunderstood due to the overwhelming amount of information being taught. So let’s look at why we would check ketones, how to check them, what the colors on the strips mean, and what to do if ketones are present. Why Check Ketones: When someone with type 1 diabetes does not not get enough insulin, their blood sugar levels rise, so the body is forced to use fat for energy. When fat is used for energy for an extended period of time, ketones develop. Ketones are a waste product of fat. If someone with type 1 diabetes does not get enough insulin, diabetic ketoacidosis (DKA) can develop. The length of time it takes and how high one’s blood sugar are varies, however DKA can occur in a few hours. Symptoms of DKA: high blood sugars ketones in blood and urine nausea, vomiting, and abdominal pain confusion lethargy (tired, sluggish, weak) difficulty breathing unconsciousness DKA is a very serious and life threatening situation. Speak with your health care providers to determine how you are to treat ketones and when you are to go to the emergency room. When to check ketones: Your doctor can tell you exactly, but usually when your blood sugars are over 250, especially if the blood sugar is not responding to insulin and remaining high after the second blood sugar check. Always check ketones when your child is sick, even if blood sugar numbers are not high. Anytime your child has nausea and vomiting, check ketones. How to check ketones: Ketones can be checked by using ketone urine strips. To check ketones, urinate on a strip, or collect urine and dip stick into ur Continue reading >>
Excess ketones are dangerous for someone with diabetes... Low insulin, combined with relatively normal glucagon and epinephrine levels, causes fat to be released from fat cells, which then turns into ketones. Excess formation of ketones is dangerous and is a medical emergency In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketones can develop. What are ketones and why do I need to know about them? Ketones and ketoacids are alternative fuels for the body that are made when glucose is in short supply. They are made in the liver from the breakdown of fats. Ketones are formed when there is not enough sugar or glucose to supply the body’s fuel needs. This occurs overnight, and during dieting or fasting. During these periods, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin, and relatively normal glucagon and epinephrine levels causes fat to be released from the fat cells. The fats travel through the blood circulation to reach the liver where they are processed into ketone units. The ketone units then circulate back into the blood stream and are picked up by the muscle and other tissues to fuel your body’s metabolism. In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketone Continue reading >>
Ketones: Clearing Up The Confusion
Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>
What Are Ketones In Urine?
What are ketones? How do they get into your urine, and why should you care? Ketones are everywhere in nature and in our bodies. We couldnt live without them. Proteins and fats are largely made of them. Our bodies normally run on glucose we get from food. When bodies dont have glucose because of starvation or illness or cant use glucose because of a lack of insulin, they start burning fat for energy. The fat breaks down into ketones, with these ketones pouring into the blood and some passing into the urine. This release of ketones into the urine is called ketonuria (pronounced KEY-tone-ER-ee-uh). The buildup of ketones in the body is called ketosis (key-TOE-sis.) If your glucose is close to normal and you are well-hydrated, ketosis is no problem. Many low-carb diets create ketosis on purpose, as it can be an indicator of fat burning and weight loss. However, ketones are acids. If you have too many ketones, they can make your blood too acidic. This can lead to a very dangerous and often life-threatening situation called diabetic ketoacidosis (DKA) . Remember, ketones appear in blood and urine because the body is breaking down fats for energy. It should only happen if glucose is low. If you have above-normal glucose and also have ketones in the urine, something is seriously wrong. Most of the classic symptoms of diabetes are symptoms of ketoacidosis: In people with Type 1 , ketonuria means theyre not getting enough insulin. Insulin keeps fat from breaking down, so ketones should not form if youre taking enough insulin. People with Type 2 can develop ketonuria if they have severe infections, major trauma, or stress. These conditions raise the need for insulin. People can have internal infections without being aware of them. A study in Chicago evaluated 138 consecutive admi Continue reading >>