Symptoms And Detection Of Ketoacidosis
Symptoms These symptoms are due to the ketone poisoning and should never be ignored. As soon as a person begins to vomit or has difficulty breathing, immediate treatment in an emergency room is required to prevent coma and possible death. Early Signs, Symptoms: Late Signs, Symptoms: very tired and sleepy weakness great thirst frequent urination dry skin and tongue leg cramps fruity odor to the breath* upset stomach* nausea* vomiting* shortness of breath sunken eyeballs very high blood sugars rapid pulse rapid breathing low blood pressure unresponsiveness, coma * these are more specific for ketoacidosis than hyperosmolar syndrome Everyone with diabetes needs to know how to recognize and treat ketoacidosis. Ketones travel from the blood into the urine and can be detected in the urine with ketone test strips available at any pharmacy. Ketone strips should always be kept on hand, but stored in a dry area and replaced as soon as they become outdated. Measurement of Ketones in the urine is very important for diabetics with infections or on insulin pump therapy due to the fact it gives more information than glucose tests alone. Check the urine for ketones whenever a blood sugar reading is 300 mg/dl or higher, if a fruity odor is detected in the breath, if abdominal pain is present, if nausea or vomiting is occurring, or if you are breathing rapidly and short of breath. If a moderate or large amount of ketones are detected on the test strip, ketoacidosis is present and immediate treatment is required. Symptoms for hyperglycemic hyperosmolar syndrome are linked to dehydration rather than acidosis, so a fruity odor to the breath and stomach upset are less likely. How To Detect Ketones During any illness, especially when it is severe and any time the stomach becomes upset, ketone Continue reading >>
When To Worry About Ketones
“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>
Ketones In Urine – How To Test And What Levels Are Optimal
There are likely two reasons you want to test the ketone levels in your urine: REASON 1 – you’ve got type one diabetes (or type two diabetes, in some cases) and you need to test the ketones levels in your urine to help you avoid ketoacidosis. If that’s the case, skip down to the sections on… Then, skip straight to the section on… REASON 2 – you’re on the Keto diet and you want to use urine strips to check if you’re in ketosis. If that’s the case, then don’t worry we’ll also cover: But skip the section on ketoacidosis – it doesn’t apply to you unless you’re diabetic! Note that information contained in this article (and website) is not intended to and shall not convey or recommend any medical or nutritional advice or course of action. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professionals. All opinions expressed in this article are based solely on personal experiences and research. We are NOT licensed doctors, dietitians, or nutritionists. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com What are ketones? First things first – a quick 101 intro on what ketones actually are: Ketone bodies (or ketones) are produced by your liver during the break down of fatty acids when your body is low on glucose. Your body then uses these ketone bodies as fuel. You see, your cells can’t directly use the fatty acids in your fat stores to produce energy. And that’s because those fatty acids are unable to pass through the membrane which surrounds your cells. And if they can’t get inside? They can’t be used as fuel. So there’s an extra step to the process: First, the fatty acids travel to your liver where they’re broken down into ke Continue reading >>
Blood In Urine And Ketones?
jay711 wrote: I'm starting a new job soon, but before I'm given an official offer I have to be tested for alcohol and drug abuse. I had the test yesterday, which involved a urine test. My urine was very yellow, and the doctor asked if I had been drinking enough water as it usually means a person is dehydrated. Then the doctor put a strip in my sample. She said the strip indicated that my urine seems to have blood in it and ketones (not sure of the correct spelling). She said ketones are usually present in diabetics... but if I was diabetic then the strip would have shown glucose aswell as ketones, but as there was no glucose it's unlikely to be diabetes. She also said ketones are common in people who are hungry for a long period of time.... my diet has been very poor lately due to work pressure and I'm only having 2 meals a day. The thing that concerns me is the blood in the urine. The blood wasn't visible to the naked eye. She said sometimes it can be discolouration due to something you've eaten like beetroot, but I haven't eaten any beetroot lately, althought I did have tomatoe ketchup on my fries just before the test, could this be one of the causes? I forgot to mention it to her at the time as I wasn't thinking straight and was in a bit of a panic. She said it could be a local infection, but I don't experience any discomfort or pain when urinating and everything seems to be ok. Anyone else ever experienced something similar or know what the cause may be?? First, and don't take this the wrong way, it kind of bothers me when people leave the doctor's office and still have huge questions. Is it that the doctor didn't seem approachable? Is it that you feel uncomfortable asking questions of the doc while at the office? Or is it that the questions didn't pop up until afte Continue reading >>
What Good Is Urine Testing For Diabetic Pets? – Part 2
Last week’s newsletter was about the value of running a periodic urinalysis – not just for diabetics but for pets who are ill or as screening tests for senior pets. Clearly pet owners won’t be able to run the microscopic portion of a urinalysis, but there are urine dipsticks available that can be run in the home that may help you and your vet make decisions about your pet’s management. The most valuable bits of information on these dipsticks for diabetic pet owners are the glucose and the ketone tests, but many dipsticks have other information beside glucose and ketones. Glucose: Urine glucose used to be an important part of diabetic pet home management. You caught that, I said “used to be”. This kind of went by the wayside when home glucose monitors became so darned accurate and easy to use. Urine glucose testing gives us a general idea of what a pet’s blood glucose is over the span of time since the pet last urinated. If the urine glucose square on the dipstick comes up really high then clearly this indicates higher glucose in the urine which indicates higher glucose in the blood. If the square has little or no glucose showing then the glucose didn’t or barely exceeded the kidneys’ glucose threshold. Now comes the tricky bit: we don’t know exactly what the threshold is for dogs and cat for when glucose spills over into the urine at the level of the kidneys. We’ve got a range, but it may be different for individual pets. In general we find glucosuria when the blood glucose exceeds the mid 200’s in dogs and somewhere between the mid 200’s to 300-ish for cats. So then why can urine glucose testing be useful with all this guessing? Perhaps the most common indication is for a kitty who is going into diabetic remission! Say you feed low carb food, Continue reading >>
Urine Tests During Pregnancy
Urine tests provide your doctor or midwife with important information about diseases or conditions that could potentially affect you or your growing baby. That's why at each prenatal visit, you'll be asked to give a urine sample as part of your regular exam. This sample is used to help determine if you have diabetes, kidney disease, or a bladder infection by measuring the levels of sugar, protein, bacteria, or other substances in your urine. The test is routine and painless and could prevent a lot of trouble down the road. What does a urine test involve? Urine can be collected any time of day. You will most likely be given a sterile cup to collect a sample before your exam. Before urinating, use a sterile towelette to wipe your genitals from front to back, and then release a small amount of urine into the toilet -- this prevents the sample from being contaminated with bacteria or other secretions that may invalidate the results. Put the container in your urine stream, and collect at least one to two ounces. This sample is then checked with chemically treated testing strips or sticks, and the results are usually available right away. If more analysis is necessary, your urine may be sent to a lab for additional assessment. What can a urine test detect? Sugar Typically, there is very little or no sugar (glucose) in urine during pregnancy. But when blood sugar levels in the body are too high, excess sugar can end up in the urine. This can be seen with gestational diabetes, a form of diabetes that only develops during pregnancy. It occurs when pregnancy hormones disrupt the body's ability to use insulin, a chemical that turns blood sugar into energy. A doctor often orders a blood test for diabetes early in your pregnancy if he or she knows you have other risk factors, like a 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 >>
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 >>
What Causes High Ketones In A Canine?
A dog with a high level of ketones in his urine suffers from a condition known as ketonuria, usually resulting from a buildup of these substances in the dog's blood. A ketone is a type of acid, which, if allowed to accumulate in the blood, can lead to ketoacidosis, a potentially fatal condition. The main health conditions that can cause high ketone levels in a canine are starvation and diabetes. A dog's body breaks down the food that he eats into sugars, also called glucose, that the cells of the body use for energy. The dog's pancreas then produces the hormone insulin to regulate the amount of glucose that the body will absorb. If the insulin to regulate the glucose is insufficient, typically due to chronic diabetes mellitus, the body breaks down alternate sources of fuel for its cells; a dog's body that is starved of nutrition will do the same. One of these sources is the fat stored in the dog's body. When the body breaks down this fat, it produces as a by-product toxic acids known as a ketones. These ketones then build up in the dog's blood and also his urine, leading to ketoacidosis. Always consult an experienced veterinarian regarding the health and treatment of your pet. A dog suffering from high ketone levels in his blood and urine exhibits symptoms of weight loss, vomiting, increased thirst, decreased appetite, increased urination, lethargy, low body temperature and yellowing of the skin and gums, according to PetMD. The dog's breath may also have a sweet, fruity smell due to the presence of acetone caused by ketoacidosis, says VetInfo. To properly diagnose high ketone levels and ketoacidosis in your dog, a veterinarian will take blood tests and a urinalysis, which will also check your dog's blood glucose levels. Depending on the dog's physical condition, hospit Continue reading >>
Urine Ketones - Meanings And False Positives
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4). Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>
Ketones In Gestational Diabetes
As part of your gestational diabetes management, your doctor may ask you to test for ketones in your morning urine. If you have gestational diabetes, you should know about insulin, glucose, and ketones. When you eat, your body breaks down foods into usable sources of energy. Glucose is the sugar that results. Your body needs glucose for energy and your baby needs it to grow. In order to get glucose out of your blood and into your cells, insulin is required. Insulin is a hormone that you produce in your pancreas. "In gestational diabetes, hormones produced during pregnancy can interfere with insulin and make it hard to use glucose. If the pancreas cannot produce enough insulin to overcome the effects of the hormones, the blood sugar will rise," explains Louise McDonald, RN, clinical manager of maternity and pediatrics at Cleveland Clinic Home Care. "The body cannot use sugar without enough insulin. That causes the body to break down fats as a source of energy. Ketones are the waste products that are left over when the body burns some of its own fat for fuel. The ketones pass from the bloodstream into the urine," says McDonald. Why Are Ketones Important in Gestational Diabetes? The treatment of gestational diabetes is aimed at keeping your blood sugar under control. This is done with a combination of diet, exercise, and sometimes insulin treatment. Finding ketones in your urine is a warning sign that your blood sugar control is out of balance. High blood sugar. If you are taking in more sugar in your diet than your insulin can manage, your blood sugar goes up. This is dangerous for you and your baby. If your baby is exposed to more sugar then the baby needs, the baby will grow too fast. This condition, called macrosomia, can lead to problems during delivery. Low blood sug Continue reading >>
Should I Test My Urine For Glucose And Ketones?
Finding glucose in the urine of someone who has not yet been diagnosed will sometimes be a tip-off that they have developed diabetes, but glucose doesn’t appear in the urine unless the blood sugar is around 240 or even higher for many people, so there is no real reason to test the urine for sugar because it isn’t helpful in managing your diabetes if all you know is that you are roughly under 240. On the other hand, ketones in the urine is a sign that you may be getting seriously ill. Routine monitoring of ketones isn’t necessary, but it should be done if you feel sick, especially if you have type 1 diabetes. If you have diabetes and there are ketones in your urine, it’s time to contact your healthcare provider. Diabetes experts don't recommend testing your urine for glucose because this method is not as accurate as checking your blood. But testing your urine for ketones can be very important in managing your diabetes. Check with your doctor to see if you need to monitor your ketone levels. You may need to do ketone urine checks if your blood glucose is more than 300 milligrams per deciliter (mg/dL) or if you're sick with the flu, a cold or a stomach bug. If you are having symptoms of high ketones -- feeling tired all the time, thirst or dry mouth, flushed skin, mental confusion, difficulty breathing or a fruity smell on your breath -- it can be a good idea to check your ketone levels. Urine testing is not an accurate way to measure blood glucose. It is the way to check for ketones when you cannot eat or are ill. A buildup of ketones tells you that you are developing ketoacidosis. Ketones are breakdown products of fat that produce acid in the body. Too much acid can result in you being hospitalized. Therefore, when you are sick with a cold or the flu, you should 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 >>
Urine Test Types: Ph, Ketones, Proteins, And Cells
Urine as a Diagnostic Tool A long time ago, disgusting as it may be, people used to actually taste and drink urine in order to try and diagnose a patient's disease! I'm not even kidding you. Thankfully, modern-day doctors do not have to resort to such disgusting and even dangerous methods. One of the reasons the doctor barbers of yesteryear used to drink their patient's urine was to see if it had a sweet taste, often indicative of diabetes mellitus. Finding the sweet-tasting glucose in the urine was covered in detail in another lesson, so we'll focus on other important measurements here instead. Interpreting Urine pH One value that can be measured in the urine is known as urine pH. pH is a measure of the acidity or alkalinity of a substance. If the pH is low, then it is acidic. If the pH is high, then it is basic, or alkaline. To remember which is which, I'll give you a little trick that has worked for me. If you grew up watching cartoons, you probably saw some comical ones where cartoonish robbers poured acid on the roof of a bank vault and waited while the acid ate its way downward into the vault, so the robbers could get down there to steal all the cash. If you can recall that acid likes to eat its way downward into things, then you'll remember that acidic substances go down the pH scale. That is to say, their pH numbers are lower than basic substances. Normal urine pH is roughly 4.6-8, with an average of 6. Urine pH can increase, meaning it will become more basic, or alkaline, due to: A urinary tract infection Kidney failure The administration of certain drugs such as sodium bicarbonate Vegetarian diets On the flip side, causes for a decreased, or acidic, urine pH, include: Metabolic or respiratory acidosis Diabetic ketoacidosis, a complication of diabetes mellitus Continue reading >>
Caution: Don’t Get Caught With Ketones
Ketoacidosis is an extremely serious diabetic complication that can lead to coma and even death. Unfortunately it is also fairly common. The good news, however, is that with proper care and an eye towards prevention, this costly and dangerous complication can be avoided. What Is Ketoacidosis? When there isn't enough insulin present for the metabolism of glucose, or when insufficient food has been eaten to satisfy energy requirements, the body burns fat for energy. Ketones are toxic, acidic byproducts of this process. Ketones are normally processed by the kidneys and excreted in the urine. But when more ketones are produced than the kidneys can handle, they can build up in the blood and lead to a dangerous condition known as diabetic ketoacidosis (DKA). Ketoacidosis raises the acidity of the body, which leads to "a cascade of problems throwing off a number a parameters in the body," says Cindy Onufer, RN, MA, CDE, the diabetes research and clinical care coordinator at Oregon Health Sciences University. Ketoacidosis rarely occurs in people with type 2 diabetes, who usually do not suffer from insufficiency of insulin, but is of great concern to those with type 1 diabetes. In fact, ketoacidosis is the number one cause of hospitalization for children with known diabetes in the United States. However, these hospitalizations are completely preventable if a urine ketone test is done and a care provider is called when indicated, says H. Peter Chase, MD, with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado. Timely testing and prevention are of utmost importance as the condition can cause coma and death if proper treatment is not administered quickly. Higher ketone levels are a warning sign that your diabetes is out of control or that you may be in danger of ke Continue reading >>