Best blood ketone HOME test

I see prior discussions of accurate home tests for DKA but they are older posts. Does anyone have current information about accurate home BLOOD tests for DKA? I have used the uring tests but want something more accurate and want to buy a blood ketone test. There are dozens and dozens of them for sale on Amazon!
Thanks for your help.

I use this one:

There is no test for DKA per se.
There is a test for ketones but DKA is when the level of ketones pushed your blood ph outside of the normal range
Causeing extreem insulin resistance and nausea, coma and death.

A diagnosis of dka comes from high urine ketones and your presentation of symptoms

I also use Precision but only for ketones not for glucose. It is not great for glucose but right on for ketones. I have used it a number of times during clinical trials.


Out of curiosity, why do you need to know your precise ketone level? Do you have specific treatment parameters based on ketone levels?

In my experience, I pretty much just check if I feel ill for peace of mind or so I know if I need to dose extra insulin. For that, the urine dipsticks are plenty good enough.

I understand the need for precise data when doing a clinical trial, but not in my everyday life.

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I had been high all day (thank you malfunctioning Pod) and finally took a ketone test. It came up with the color corresponding to 1.5 and the insurance nurse line said “go to the ER”. It seemed to me that a little different color either way could have saved me that trip. I need to buy more ketone test strips anyway since they expire 90 days after opening.

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Did he/she base this only on that ketone test, or ask for more info? You knew the cause, assume you took insulin and fluids.

Here are some guidelines

Yeah, this is one of my big frustrations with nowadays. They used to teach us how to deal with ketosis to avoid the hospital. As @MM1 pointed out, fluids and insulin, but also electrolytes. Especially potassium, because that’s wicked nasty to get in an IV drip. And you may need to keep this up even after your BG returns to normal, which means also dosing with carbs to counteract the insulin you need to keep taking. Now, it’s like nobody knows what to do anymore, or more likely they don’t trust us to self-manage, so “go to the hospital!” is the default response.

I think as a kid they didn’t want to reward ketoacidosis with tasty treats, so the ritual was Pedialyte for the fluids/electrolytes, a shot for the insulin, and a tablespoon of coke syrup (used to be sold in the pharmacy, and it was gross!) every 15 minutes for the carbs. Now, I’m happy to drink tasty coconut water for carbs, fluid, and potassium all in one.

I would highly suggest you call your endo’s office next time, or whoever you see for your diabetes. They can better advise you than your insurance company, who is only really concerned with liability. The doctor’s office can coach you through self-management, but also advise you when it really is time to go to the ER. It’s every bit as much about symptoms, which indicate how well you’re handling the ketones, as it is about the quantity of ketones. For me, I know the point of no return is when I start vomiting. It’s a quick downhill slope after that. Thankfully it’s been more than 20 years since I’ve gotten to that point. Now that I’m under much better control, though, I have almost no tolerance for ketones, so I have to be even more vigilant!

And honestly, the urine dipsticks are good enough for the doctors office. It’s probably what they’re using in office, so there won’t be anymore specific protocols in place than what their strips indicate. The nurse or whomever you speak to probably wouldn’t care about a more exact number.

Of course, likes of people prefer the blood tests, I guess. I just don’t get it, personally.


Blood sugar and blood ketones aren’t correlated; we can have high ketones without high bg. Knowing when our bg is high is sort-of possible, but unreliable (I can get to 200mg/dL and not realize it). Detecting ketones is not easy unless you have someone around you how knows the symptoms - the smell is very obvious, but not to the person emitting it.

So when I go particularly high I invariably check my ketones. I do that using the Precision Xtra, which others have recommended; it’s relatively cheap because the keto-diet guys use it too. I do not have the pee strips even vaguely useful - the meter gives me a number and, while it may or may not be exact, I know when to panic given the number (I start to panic when I’m heading towards 1).

The pee sticks should give a result with manageable but high BG - anything over 250mg/dL. The difference is that if I am over 250 because I just ate a whole load of ■■■■ I don’t have a problem, if I’m there because my pump has a bent canula that’s completely different.

Everyone should have a ketone meter. Anyone tried using a pee stick in the middle of a restaurant?

If you are type 2 or a type 1 on long acting insulin, it’s nearly impossible to get into dka.
People on pumps are at highest risk because if there is an occlusion or your set comes out, you can be in DKA rather quickly.

That doesn’t mean you won’t have ketones in your blood and urine.
Dka means the level of ketones in your blood causes your blood to be more acidic. And if it gets too far out you can go into a coma.

As long as you have SOME insulin on board, you won’t get into DKA.

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We use the Keto-mojo blood ketone test strips plus blood ketone meter. Knowing our daughter’s blood ketone level (typically I need to check when she’s sick) has saved us quite a few trips to the ER. I really recommend having one of these. Much better than the urine strips.
The strips and meter are not cheap but it’s worth it to me for the peace of mind.

I too swear by the Keto-mojo meter as it is very quick and accurate for measuring keytones. For blood glucose I use the Contour Next One meter even though Keto-mojo will do both blood glucose and keytones, I use the most reliable meter for each function.

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I prefer my blood ketone meter because the urine ketones can be quite behind in my case. For me, it’s several hours. Higher ketone levels increase my insulin resistance and require larger amounts of fluid and electrolyte replacement for me. In fact, even if I am not high, I can get large ketones if I am otherwise sick, and knowing I have them helps me know to adjust my ratios. And, yes, if I were ill and they remained very high for long enough and didn’t go down with fluids and insulin and such, I would take myself to the hospital. Mostly, if I had lots of ketones but felt too queasy/exhausted to keep up the drinking and checking and bolusing.


Thank you. That’s the first logical reason I’ve ever seen, and makes perfect sense. I never considered time to be critical with ketosis since it takes a while to escalate into full blown ketoacidosis… Or so I thought. It’s good to be reminded that this is different for other people.

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Yes, it’s interesting how we’re all different. For me, my body is quite prone to ketones, though not necessarily DKA. (Though, actually, who knows? It’s not like I can test my blood ph at home, and I generally manage even if I am extremely ill, so it just doesn’t get that far. Maybe I would be if I couldn’t manage it so exactly.) Right now, I think I need about 15 percent more insulin with mild ketones, and I need about 30 percent more with large ketones. If I sleep longer, I get ketones from “fasting” too long, no matter my blood sugar, and figuring that out made it easier to understand why I sometimes needed more insulin than usual at my first meal of the day. I also tend to go low once the ketones fade because that insulin is still active. It’s good to know because I can see if they’ve gone down, and if they have, be prepared to dip soon. The urine strips still have a place in my cabinet, but they can’t tell me that in time.

I suspect we all are; we all have “low carb” diets and, by some definitions they are “keto” diets. A couple of days ago I was passing through the WinCo checkout and there was one of those mags called “Keto Diet”. The picture on the front was definitely a serious insulin undertaking for me (about 40-60g; mainly the tomato, though it looked like it had a suspicious sauce too.)

This is a good thing; if we produce ketones as a result of the keto diet it is because we are metabolising protein and fat to glucose. This takes a long time so is easier to handle with the very slow adsorption insulin methods we have.

One good rule is that high ketones with low blood sugar are not an issue and to be expected (gluconeogenesis seems to be at least partially a function of not having more readily available glucose). High blood ketones with high blood sugar indicate a problem; so I don’t even get out the ketone meter until I’m heading toward 300mg/dL.


Yes, for me, it’s not that the ketones are necessarily bad on their own in occasional, moderate amounts. It’s just that, when they’re there, I have to adjust my ratios a bit, regardless of normal blood sugar. I’m less insulin sensitive when I have ketones, and when they fall, I become more insulin sensitive again. I once met with a nurse who was also a CDE in a pregnancy clinic, and she told me she’d seen increased insulin resistance in her patients over there, too, when they had normal blood sugar and ketones, which I thought was interesting. You’re definitely correct about the fact that most of us eat fewer carbs than people who have functional pancreases. I forget that sometimes. I used to eat very low carb, but I don’t anymore, so I consider my current diet much higher, even though it’s significantly lower in carbs than what many non-diabetics eat.

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Not necessarily true! See item 5 in the attached link:

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That’s a consistent theme that I’ve seen here and on TUD for that matter; normally identified as with high bg, but the levels I’ve seem imply that high ketones would be there too. It would be good to have a CKM.

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