I must admit…it has been 25 years since the last time I checked for ketones. I read all the time on Diabetic message boards of people checking for ketones. When my blood sugar reaches 250 mg/dl or 13.8 mmol, I basically get my blood sugar under control and per my endocrinologist I am to drink a few glasses of water.
I’ve never let my sugars stay at the 250 mg/dl or 13.8 mmol for a long period of time. Are there others out there that do not check their ketones?
I would love to hear from people that regularly check ketones and how you benefit from testing.
I have never checked for ketones in my 36 years of D. As soon as I noticed bg above 200 I brought it down. No lab test ever turned up ketones. Since I got my CGM my bg consistently stays below 200. I even had some weeks where my bg stayed below 160 at all times.
I rarely ck, either. I guess I don’t feel like it tells me that much. It’s not like it’s going to change what I do. Like you, I correct and drink water to get my b/g down. Having ketones isn’t going to change that. In times past, when I have ck’d for ketones, and my b/g has been hella high they’ve always been trace if measurable at all, so what’s the bother?
Hi Danny,
I’m with you on this one. I get the occasional 200+ BG spikes now and again, but very rarely do I get them for a sustained length of time. Of all the guides I’ve seen, all I’ve heard to remedy the ketones is (1) lower your BG and (2) drink lots of water to flush the system. There’s nothing else to be done. Whoopdey do! So even if I know I’ve got ketones, what am I to do?
(1) lower my BG, and
(2) drink extra water.
I feel like Einstein.
Cheers, Mike
I used to check for ketones when I was over 200 mg/dL way back when I used a BG meter which supplied about 10 ketone test strips in every box of 100 glucose test strips (the Precision Xtra meter). I never saw any ketones whenever I checked. So, when I moved away from that meter to OneTouch, I didn’t have any ketone strips anymore and never bothered about that.
I tended not to worry about ketones when I was on Lantus because from what I had understood, ketones are not a problem as long as there is some basal insulin in your body. But now that I’m on a pump, I have begun worrying because if my pump site has had problems resulting in elevated numbers, then I probably do have ketones. Of course, once I realize that I’m above 200 mg/dL, I bolus to bring down my number quickly.
I do not check them either, The few time i have they were negative,
Add me to the list non-ketone checkers. Drink water, correct, test, move on.
I check for ketones to decide if I may have a problem with my insulin pump. So basically i check when I have a high that I can’t explain.
If I am 300 mg/dl because I ate a big piece of cake and gave insulin --> no ketones.
If I am 300 mg/dl because my infusion site has a problem or I inserted into scar tissue —> ketones.
I also test when I am nauseated or feeling weak with a high. One day I woke up only moderately high (160 mg/dl) and felt nauseated, so I tested my urine ketones and they were high. No idea why. Therefore I started spot checking ketones at my second urination and found that in the morning I have mild ketones with normal blood sugar. These are supposedly just from fasting… but they apparently last a few hours. Not sure if this is normal??? Anyone know?
Does the presence of ketones (without high blood sugar) cause any damage?
(OK, I guess that was less of a reply and more of a bunch of questions about ketones!)
From random googling, I got this site http://www.diabetes.co.uk/diabetes-and-ketones.html which included information I’ve pasted below:
When should I test for ketones, and how will this affect the management of my diabetes?Your GP or healthcare team will be able to inform you of the best possible time for you personally to test for ketones. However, it is generally understood that testing should take place when fasting (i.e: when food has not been consumed for eight hours or more) and any of the following occurs:
- Blood sugar is on or above 250 mg/dl for two consecutive tests
- When any illness occurs (as even the most minor can cause ketones)
- If you vomit or suffer from diarrhoea
- You suffer from depression or stress
- You fall pregnant
The test will not interfere with the management of you diabetes.
I am diabetic and my ketone test is positive, what should I do?
Contact your healthcare team, and explain the situation to them.
Should the tests show very small amounts of ketones take the following actions:
- Drink water every hour, and continue testing every three hours.
- Do not exercise.
- If your ketone levels do not fall after two tests contact your healthcare team.
- If the test shows moderate or high ketone numbers then telephone your doctor at once, and drink water.
I think I might have ketoacidosis, how would I know?
If you are suffering from DKA (diabetic ketoacidosis) then early signs would be likely to include: stomach pains, nausea and/or vomiting, breathlessness, breath that smells of fruit. In this instance, call your doctor as soon as possible. Ketoacidosis is an extremely severe condition.
Presence of ketones without accompanying high BG doesn’t cause or indicate damage. If the ketones were really high consistently after drinking water (& correcting, if needed), something’s going on that warrants medical attention. Ketones are a normal by-product of burning fat for energy, so maybe you were having active dreams:)
I wonder if mild ketosis is normal in the morning because of not drinking fluids for hours. Hmmm.
Good points Gerri. I stopped testing because I seemed to consistently have mild ketosis. I might ask my endo next week.
Would you mind sharing what your endo says? I’m curious.
I have used samples and purchased the " odd " box …after I had wrist surgery 3 years ago , my numbers were running a bit hi and for abit I was bedridden …usually a trace showed up on the stick’s colour chart …I would be concerned , if I had the FLU …but never have this . Sugars Hi , drink H2O . The box with sticks has this expiry date , which always comes too soon .
I should have read you last sentence better : …you like to hear from people , that check regularly …NOT ME , ha, ha .
Like you Danny…it’s been about 25 yrs for me too since I checked for ketones. If I do run high, I take care of it to get it back under control. I have wondered how many people regularly check for ketones as well.I actually see my DR tomorrow so I’ll probably ask her about it too! Good question. 
i guess i am special then
or weird i guess
i had some dark times in my 9 months of diabetes(yeah,9 months)
-it was really,really normal for me,to eat,and not take insulin(i know,pretty bad)
-it was even more normal for me,to check,see a 300 bg,and react to it as if someone said,the light is on,if i was in a good,motivated mood that day,i would correct
-sometimes a day may pass without me checking
-it was the most normal thing in my world not to take my lantus for 2 days,but in that case,i would take novorapid for meals
-when counting carbs,i always estimate,never absolute,but i am good at guessing carbs anyway
yet
i test for ketones!
i guess because i like to know what my number is,usually there is none,but sometimes(rarely) they are mild
and because i like to connect things to each other,for example"
1-if i haven’t had my novorapid for two days,but i took my lantus, (no ketones)
2-if i took my novorapid,but no lantus,for 1 day (small amount of ketones)
3-if i took no insulin at all (moderate amount of ketones)
4-if i was sick,no lantus (same above)
5-i was sick,no insulin at all (large amounts of ketones)
i know it’s pretty bad,treating my body as if it was a lab rat!but it’s not as bad as it seems,really
and anyway,i think i passed those dark ages
sorry for talking a lot 
I just wanted to follow up because I did ask my DR last week whether its really necessary to be checking for ketones or not when and if my blood sugar gets high. She told me it wasn’t really necessary unless I started to get abdominal pains and/or signs of DKA. She said the best thing to do is to drink a lot of water and keep checking blood tests to make sure they were coming down(of course I already knew that though! ;)). I’ve never gone into DKA but came close with my first insulin pump when it wasn’t working properly and blood sugar kept rising and I didn’t know what was going on. I almost ended up in the ER but got it down without going. I was told by my DR at the time to change the pump set(pod at the time), give regular shots of Novalog straight down into the muscle in my leg to make insulin absorption better (he gave me doses to go by until it came down to make sure I didn’t end up going too low) and had me keep checking my blood sugars every hour as well as drinking a lot of water. He said if it didn’t come down I would need to go to the ER. Eventually it was stabilized and it came down to normal again thankfully doing that so I avoided an ER trip on that one!
I was at my endo today as well and I asked.
He said that unless I also have symptoms of DKA, then there is no point in testing ketones.
If my blood sugar is high, I should take insulin (with or without ketones). So measuring ketones doesn’t really give new info. He told me there is really no reason for me to be measuring my fasting ketones (except during pregnancy when it can tell if you are eating enough for the baby). He said that having ketones after a period of fasting is totally normal.
Thanks for the update. Makes sense & what we all suspected.
Interesting about testing during pregnancy. That makes sense also since not enough food would mean the body is burning fat instead.
Actually high ketones with normal BG can be a problem… but only if you are extremely dehydrated and unable to get/stay hydrated on your own (like with a stomach virus). It doesn’t mean DKA though… just that you’re severely dehydrated, which COULD accelerate DKA if your BG were to climb… not to mention that high levels of ketones on their own can cause nausea/vomiting, not to mention that horrible headache. A trip to the ER and fluids is still in order (and you’ll usually walk out feeling a million times better).
I test ketones for any high that I can’t easily explain… ketones with a high BG for me usually means I have a failing infusion site, or the cannula is bent or came out and I can’t see. I only worry if I get moderate or higher.
I have never in my 36 years of Diabetes tested for ketones. After reading on this sight about people testing I asked if I should be the last visit to my endo, he said it’s really only necessary when sick.