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Urine ketone testing

Patient Education
Last reviewed

Your body cells use sugar for energy. Insulin must be present for your body cells to use sugar for energy. When there is not enough insulin present your cells cannot use sugar to obtain the energy they need. If your body cannot get energy from sugar, fat is used instead. When fat is broken down, ketones are made. Ketones are strong acids and are harmful to your body. Ketones in your urine may be a sign that you are developing diabetic ketoacidosis.

When should you test your urine for ketones?

  • If your blood sugar tests are higher than 250 mg/dL for two or more tests in a row
  • If you are feeling like your blood sugar is high
  • If you think you have an infection
  • If you are throwing up or feel sick to your stomach
  • If you are ill or stressed
  • If you have Type 1 diabetes, you should always have a supply of the strips used for urine ketone testing and know how to use them. If you have Type 2 diabetes, your doctor or nurse will tell you if you need to do urine ketone testing. If you are pregnant your doctor or nurse will tell you when to test your urine for ketones.

How do you test your urine for ketones?

There are several products that can be used to test the urine for ketones. The test strips can be purchased at a pharmacy and usually do not require a prescription.

Ketostix® test strips are commonly used to test the urine for ketones. This is the way you test with a Ketostix®:

  1. Dip the test end of the strip into fresh urine.
  2. Remove the strip from the urine and wait 15 seconds.
  3. Compare the color on the strip with the color chart on the bottle.

The urine ketone test will tell you whether you have no ketones present or if you have trace, small, moderate, or large ketones present.

If your urine has moderate or large ketones present, call your doctor or nurse right away.

Follow the directions for testing exactly and time the test accurately. Read the directions before doing the test. Protect the test strips from damage that might change the results.

  1. Do not touch the test area of the strip or allow it to touch the table.
  2. Protect the test strips from moisture, direct sunlight and heat. Keep the test strips in a cool, dry place but do not store in the refrigerator. Do not remove desiccant (white packet in bottle). Replace the bottle cap promptly and tightly.
  3. Check the expiration date on your test strips. Do not use if the date has passed. Use the strips within 6 months after first opening the bottle.
  4. Do not use test strips that have discolored.