Urine Ketone Testing

Ketones in your urine (pee) may be a sign you are starting to have diabetic ketoacidosis (DKA).

What are ketones?

• Ketones are strong acids that harm your body. They are made in your body when your cells cannot get the energy they need.
• Your body’s cells use sugar for energy. The cells cannot get sugar unless there is enough insulin to let sugar into the cells.
• If cells cannot get the energy they need from sugar, fat is broken down to be used instead.
• When fat is broken down, ketones are made. Ketones in urine are a sign your body does not have enough insulin

When should I test for urine ketones?

Test for urine ketones if:

• Your blood sugars are 240 mg/dl or higher for more than 2 tests in a row.
• Your blood sugars are over 300 mg/dL 1 time.
• You are pregnant and your blood sugars are 180 mg/dl or higher for more than 2 tests in a row.
• You think you have an infection.
• You are throwing up or feel sick to your stomach.
• You are ill or stressed.

How do I test for urine ketones?

You can buy the test strips at most pharmacies. You do not need a prescription. Read the instructions that come with the strips for proper use. 

To use the test strip:

1. Take a test strip out of the container.
2. Pass the end of the test strip through your urine stream.
3. Take the strip out of the urine and wait for the number of seconds in the instructions on the bottle (often 15 seconds).
4. Compare the color on the strip to the color chart on the bottle. This will tell you if ketones are in your urine.
5. Check every 6 hours until results are negative.

When should I call the care team? 

• Call your care team right away if you have moderate to large ketones.
• Go to the emergency room if you have ketones in your urine and cannot drink fluids.

 How do I store the test strips? 

• Keep the test strips away from moisture, direct sunlight, and heat.
• Keep the test strips in a cool, dry place. Do not keep them in the refrigerator. 

What should I do with a new bottle of test strips? 

• Write the expiration date on the bottle when you open a new one.
• Make sure this date is not after the expiration date on the bottle from the manufacturer.
• Test strips expire 6 months after the bottle is opened. Do not use them after they expire. 

What else do I need to know about the test strips? 

• Do not touch the test area of the strip or let it touch any surfaces before you use it.
• After you take a test strip out, put the cap on tight right away.
• Before using a test strip, make sure it matches the negative result on the bottle. If it does not match, do not use it.