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Blood Ketone Levels Range

Blood Ketones

Blood Ketones

On This Site Tests: Urine Ketones (see Urinalysis - The Chemical Exam); Blood Gases; Glucose Tests Elsewhere On The Web Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>

Ketone Testing

Ketone Testing

Tweet Ketone testing is a key part of type 1 diabetes management as it helps to prevent a dangerous short term complication, ketoacidosis, from occurring. If you have type 1 diabetes, it is recommended that you have ketone testing supplies on your prescription. Ketone testing may also be useful in people with other types of diabetes that are dependent upon insulin. Why test for ketones? Ketones are produced by the body as an alternative source of energy to sugar. The body produces ketones by breaking down fats, this process is known as ketosis. Ketones may be produced as part of weight loss, however, it’s important for people with diabetes on insulin to note that ketones can be produced when the body has insufficient insulin. When the body has too little insulin, it means that cells of the body cannot take in enough sugar from the blood. To compensate for this, the body will start to break down fat to provide ketones. However, if a high level of ketones is produced, this can cause the blood to become acidic which can lead to illness and even potential danger to organs if not treated in time. This state is referred to as diabetic ketoacidosis. Where can I get ketone testing kits and sensors? The most accurate way of testing for ketones is to use a meter that measures blood ketone levels. The following blood glucose meters are able to test blood ketone levels in addition to blood glucose levels: Abbott - FreeStyle Optium Neo Menarini - GlucoMen LX Plus If you take insulin, you should be able to get these prescribed by your GP. You can also test urine for ketone levels, however, urine ketone testing is not as accurate as blood ketone testing as the levels of ketones in the urine will usually only reflect a level of up to a few hours previously. When to test for ketones? Continue reading >>

Lose Weight By Achieving Optimal Ketosis

Lose Weight By Achieving Optimal Ketosis

Do you want to lose weight? Here’s number 16 of my 18 best tips. All of the published tips can be found on the How to Lose Weight page. Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungry, eating real food, eating only when hungry, measuring progress wisely, being persistent, avoiding fruit, beer and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals, using intermittent fasting and finally, exercising smart. This is number sixteen: 16. Get into optimal ketosis Warning: Not recommended for type 1 diabetics, see below. We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out the heavy artillery: optimal ketosis. Many people stalling at weight plateaus while on a low carb diet have found optimal ketosis helpful. It’s what can melt the fat off once again. So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect. Video course Do you know exactly how to eat a low-carb and high fat diet (LCHF)? This is required for ketosis. If not the easiest way is watching this high quality 11-minute video course on how to eat LCHF, and the most important things to think a Continue reading >>

Ketosis & Measuring Ketones

Ketosis & Measuring Ketones

Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>

Jimmy Moore’s N=1 Experiments: Nutritional Ketosis Day 1-30

Jimmy Moore’s N=1 Experiments: Nutritional Ketosis Day 1-30

Before I went on the 2012 Low-Carb Cruise last month, I started reading a book that my low-carb research friends Dr. Jeff Volek and Dr. Steve Phinney had written as a follow-up to their fantastic 2011 release The Art And Science of Low Carbohydrate Living (listen to my interview with Dr. Phinney about this book in Episode 479 of “The Livin’ La Vida Low-Carb Show”). The sequel is called The Art And Science Of Low Carbohydrate Performance and was written specifically to share the latest science behind ketogenic diets for athletes who are keenly interested in optimizing their exercise performance with fat and ketones serving as their body’s primary fuel source once they reach what Dr. Phinney refers to as “keto-adaptation.” But the information these low-carb stalwarts provide in this handy dandy little book goes much deeper than that as you will read about in this blog post. Most low-carbers have traditionally been using urine ketone sticks under the brand name Ketostix to measure their level of ketones being produced by color (from pink to dark purple) as a result of their low-carb diet. But as I previously shared in this YouTube video, this can be a frustratingly inaccurate way of measuring whether you are producing enough ketones in your blood to see the kind of results you are hoping for on your low-carb lifestyle change. But thanks to the cutting-edge information provided by Volek and Phinney in The Art And Science Of Low Carbohydrate Performance, we now have a new and better way to measure the actual ketones that are in your blood which determines whether you have become keto-adapted and burning fat and ketones for fuel. They refer to getting into this state as “nutritional ketosis” to obviously distinguish it from ketoacidosis which is only an issue Continue reading >>

Getting To Know Ketones

Getting To Know Ketones

People with diabetes, particularly those with Type 1 diabetes, have been at least vaguely aware of the word ketones for a long time. With the recent resurgence of popular interest in low-carbohydrate diets, however, just about everyone seems to be talking about ketones these days. But does anyone really know what ketones are? Are they a danger to your health (as in diabetic ketoacidosis), or a sign that you have lowered your carbohydrate intake enough to cause weight loss (as some people who follow low-carbohydrate diets believe)? What are ketones? Ketones are end-products of fat metabolism in the body. That is, they are formed when fat is burned for energy by the muscles. Chemically, they are acids known as ketone bodies, and there are three types: beta-hydroxybutyric acid, aceto-acetic acid, and acetone. But you don’t have to be a chemist to understand what role they play in the body. To get to know ketones, it’s helpful to understand how your body burns fuel. A simple analogy is that of an automobile. For a car engine to run, the engine must burn fuel (gasoline), and when the fuel is burned, exhaust (carbon monoxide) is created. The carbon monoxide is the end-product of gasoline combustion. Your body also has an engine that must burn fuel to operate. The engine is muscle, and the fuel is fat, carbohydrate (glucose), and, in certain conditions, protein. When fat is burned, the “exhaust” is ketones, and when glucose is burned, the “exhaust” is lactic acid. Fat is more desirable as a fuel than glucose because there are more calories in a gram of fat (9 calories per gram) than there are in a gram of glucose (4 calories per gram), so you get more energy per gram of fat burned. In a sense, you could call fat a high-test fuel. But there is one catch to burning f Continue reading >>

5 Ways To Measure Your Ketones

5 Ways To Measure Your Ketones

5 Ways to Measure Your Ketones A ketogenic diet is a very low carbohydrate, moderate protein and high fat based nutrition plan. A ketogenic diet trains the individual’s metabolism to run off of fatty acids or ketone bodies. This is called fat adapted, when the body has adapted to run off of fatty acids/ketones at rest. Research has demonstrated that this nutrition plan improves insulin sensitivity and reduces inflammation throughout the body. This leads to greater fat metabolism and muscle development as well as a reduced risk of chronic disease. (1, 2). I get asked all the time how to measure the state of ketosis. There are several major ways and we will discuss those in this article. Measuring Your Ketones There are three types of ketone bodies: Acetone, Acetoacetate and Beta-Hydroxybutryate (BHB). Each of these three can be tested as acetone is a ketone released through the breath, acetoacetate is a ketone released through urine and BHB is (although not technically a ketone it acts like a ketone) in the blood stream and used by the cells for energy. 1. Blood Ketone Meter This measures BHB and is considered to be the most accurate way to measure ketone bodies. These have the ability to determine the ketone level in your blood precisely but they are also pricey and invasive. Personally, I freak out every time I have to prick my finger!! The Precision Xtra blood glucose and ketone meter is a good buy at $28-$30. The expensive part is the ketone test strips here which can cost $4 each. If you are looking at testing yourself every day it is going to cost you $120 a month and the $30 meter. Here is a starter kit you can get on Amazon Most people will enter into a light nutritional ketosis (between 0.5-1.0 mmol/L on the meter) within two or three days. It typically takes Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) is a dangerous and potentially life threatening complication of diabetes, with thousands of preventable cases each year. DKA most commonly happens in people with Type 1 Diabetes although it occasionally occurs in people with insulin-treated Type 2 Diabetes. DKA occurs when there is persistently high glucose and a severe lack of insulin. 10,434 people with Type 1 diabetes hospitalised at least once during 2011-12 ¹ 9% of children experienced DKA in 1 year ² Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period, with the first sign often being hyperglycemia. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration Deep laboured breathing (called kussmaul breathing) Confusion and sometimes even coma Click here to download the full DKA Information Brochure What are Ketones? Ketones are the by-product of fat metabolism. Ketones can provide the body with energy when glucose is not available. As you know, in order to derive energy from the carbohydrates in the foods that we eat, the body needs insulin. Insulin is the key that unlocks the body’s cells in order to allow glucose to enter to provide energy. In the absence of sufficient insulin, glucose cannot enter the cells and the glucose levels build up in the blood. Without insulin, the body begins to metabolize fat and produces ketones. Ketones can be very dangerous when the blood glucose level is high. If the blood glucose and ketones levels continue to rise, one can get very sick very quickly. The person begins to get dehydrated and acidotic, meaning that the body loses water and salts and the pH falls with a build up of acids, the ketones, developing DKA. What are blood ketones versus urine ketones You may have heard about or learned how to check urine ketones Continue reading >>

How To Read Blood Ketone Test Results

How To Read Blood Ketone Test Results

If you are living with diabetes, chances are you've probably had your blood or urine tested for ketones. When your body doesn't have enough insulin to absorb glucose it breaks down fats for energy, creating ketones as a byproduct. Everyone produces ketones, but if you have diabetes, you have a greater risk of ketones building up in your blood, which can lead to diabetic ketoacidosis. Both people with type 1 and type 2 diabetes can develop diabetic ketoacidosis. That said, it is more common in people with type 1 diabetes. Interpreting Your Blood Test Results Ketone blood testing is the preferred method for assessing the presence of ketones during times of sickness. Urine test strips can be used, but the American Diabetes Association recommends using blood ketone tests because they are more accurate and timely. Blood ketone tests use different measurements than the numbers you are familiar with on your glucose meter. When using a combination home blood glucose and ketone meter, such as the Precision Xtra Meter by Abbott Labs, or if you have your blood drawn and assessed at a lab, the results will fall into one of the following three ranges: Below 0.6 mmol/L: If your reading is below 0.6 you are in the normal range. 0.6 to 1.5 mmol/L: If your number is in this range you have the presence of ketones in your blood, which may develop into a problem if not treated. You should be in touch with your healthcare provider and follow his or her instructions. Above 1.5 mmol/L: Readings above 1.5 indicate a greater risk for developing ketoacidosis (DKA). You should immediately contact your healthcare provider for advice. Readings above 3.0 mmd/L may warrant a trip to the nearest emergency room for immediate treatment. If you are testing your blood or urine at home and are concerned ab Continue reading >>

Reference Range

Reference Range

Acetoacetate, beta-hydroxybutyrate, and acetone are ketone bodies. In carbohydrate-deficient states, fatty-acid metabolism spurs acetoacetate accumulation. The reduction of acetoacetate in the mitochondria results in beta-hydroxybutyrate production. Beta-hydroxybutyrate and acetoacetate, the predominant ketone bodies, are rich in energy. Beta-hydroxybutyrate and acetoacetate transport energy from the liver to other tissues. Acetone forms from the spontaneous decarboxylation of acetoacetate. Acetone is the cause of the sweet odor on the breath in persons with ketoacidosis. [1, 2] Ketone bodies fuel the brain with an alternative source of energy (close to two thirds of its needs) during periods of prolonged fasting or starvation, when the brain cannot use fatty acids for energy. The reference range for ketone is a negative value, at less than 1 mg/dL (< 0.1 mmol/L). [3] Continue reading >>

What Are Ketones And Their Tests?

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 >>

Exploring The Clinical Utility Of Blood Ketone Levels In The Emergency Department Assessment Of Paediatric Patients

Exploring The Clinical Utility Of Blood Ketone Levels In The Emergency Department Assessment Of Paediatric Patients

Go to: Abstract Ketonuria (on standard urine testing) is a frequent finding in children presenting to emergency departments. With the advent of hand‐held ketone meters, blood ketone levels can now be rapidly quantified. Point of care testing (POCT) of blood ketone levels could provide clinically useful information on severity of illness in children and risk of hospital admission. A prospective study using POCT of blood ketone levels in a convenience sample of children <13 years old, with a typical case mix of medical problems. Findings 186 children were studied. The range of ketone levels varied widely among this study population depending on the presenting complaint. Higher levels were noted in those presenting with anorexia or vomiting and fever. The median ketone level of the total study population was 0.2 (range 0–6.0, interquartile range 0.1–0.9) mmol/l. Ketone levels correlated poorly with discharge destination and duration of admission. However, receiver–operator characteristics for ketones as a predictor of admission were comparable to Pediatric Risk of Admission scores (area under the curve 0.64 and 0.72, respectively) and may represent an independent risk factor for admission. A ketone level >1.2 mmol/l has a positive predictive value of 66.7% for admission. Ketone levels correlated well with decreased oral intake (R2 = 0.25; p<0.001). A strong association was found between ketone levels, decreased oral intake and fever. Although ketone levels do not correlate well with more traditional markers of illness severity, they can help to predict the requirement for admission to hospital when interpreted in the context of the presenting illness. They may have applications in both the emergency department and primary care settings. Further prospective testing Continue reading >>

Measuring Ketosis: What Are Keto Sticks And Keto Strips?

Measuring Ketosis: What Are Keto Sticks And Keto Strips?

Ketosis is a metabolic state where the liver breaks down fat to produce ketones. Ketones, on a ketogenic diet, are the primary fuel source for the body. If you’re new to the ketogenic diet and you still have questions, consider reading our Comprehensive Beginner’s Guide to Keto > There are three main ways to measure the ketones in your body, all of which have their advantages and disadvantages. The most common ways to measure are: Blood Ketone Meter. Very accurate but the strips are extremely expensive. Breath Ketone Meters. More accurate than the urine strips, but can sometimes vary in accuracy. Cheaper than blood strips in the long-run. Urine Stricks. This will answer the question “Am I in ketosis?” but will not provide an accurate measure of blood ketones. Scroll down to read a more in-depth analysis of each, and what we recommend for you. Measuring Ketones with Urine Sticks Urine sticks will always be the cheapest and easiest way to measure ketosis. For beginners, this should cover everything you need – there is no point in getting more complex blood strips so early on when you are still trying to understand the nuances of a ketogenic diet. Ultimately, keto sticks are very easy to use – you hold the sticks in your urine stream for a few seconds, and within 10-15 seconds you should notice a color change in the strip (if you are in ketosis). The color of the stick typically is measured in red: light pink being low in ketone production and dark purple being high in ketone production. While keto sticks can be ideal for a general answer to the question “Am I in ketosis?”, they aren’t precise with their accuracy. They measure the acetoacetate in your urine, which is an unused ketone by the body. As you get deeper into ketosis and your body adapts, your b Continue reading >>

Ketone Levels

Ketone Levels

The classic 1983 study by Dr Phinney measured the athletes blood BOHB as 1.28 mmol/L at rest[6]. This makes me wonder if there is a "Goldilocks effect" to ketone levels. Too high may indicate too little protein, and poor glycogen stores, that may impair endurance performance. The level required to be ketogenic (hyperketonemia) has been suggested as 0.2 mmol/L measured as the combination of AcAc and BOHB in whole blood as this is slightly above the levels seen in "normal" individuals[7]. Personally, I'd argue this is too low to be considered ketogenic, as this level is seen in people on a high carbohydrate diet after a night's sleep. The book "The Art and Science of Low Carbohydrate Living" calls the range 0.5 to 5.0 mmol/L of blood ketones "nutritional ketosis"[8] The follow on book "The Art and Science of Low Carbohydrate Performance" suggests that BOHB levels of 0.5 mmol/L to 3.0 mmol/L is "optimal"[9], with benefits starting at 0.5 mmol/L and improving to 3.0 mmol/L, but levels above 3.0 mmol/L not producing additional benefits[10]. (It is unclear what research these levels are based on.) For epilepsy, the recommendation is for AcAc to be 80-160 mmol/L as measured by urine dipstick[11], though this level is not necessarily sufficient[12]. The range of 2 to 7 mmol/L[13] or 2 to 5 mmol/L[14] has been suggested in some literature as a "therapeutic" range. A study of 74 children on the ketogenic diet for epilepsy found that blood BOHB levels of greater than 4 mmol/L were correlated with better seizure control than those with lower levels[12]. A 28 day study of five Parkinson's patients on the Ketogenic Diet had blood BOHB levels averaging 6.6 mmol/L (range 4.8 to 8.9) and showed some signs of improvements, though the study was too small for any conclusions to be drawn [1 Continue reading >>

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