How long to flush ketones?

After inserting a new infusion set last night, I woke up during the night to test my blood sugar. I was 250 mg/dl (13.8 mmol/L) and when I gave a correction bolus, my (Minimed 722) pump gave me a no delivery alarm. I tested for ketones and have large amounts of ketones. I gave an injection and changed my infusion set, which seemed to fix the problem. My blood sugar came down to 81 mg/dl (4.5 mmol/L) by the late morning and I had only low ketones.

I just tested for ketones again and I still have a small amount of ketones 12 hours later. Is this normal? How long does it take to “flush” out the ketones?

Thanks for the advice! I will go drink 26 oz. of fluids now! That sounds like a good rule!

Dear Kristen. How do you test for ketones?

Hi Kristin,
I don’t have an amount to give you but my kidney doc tells me he wants me to make sure my urine is very light in color Of course I know this means drink plenty of fluids but don’t try to over drink what you need. I hope you are feeling better soon

I use Ketostix to test for ketones in urine.

I’ve been told that a trace amount of ketones is normal for anyone. As the ketones are produced by your body and have to be flushed from your system, I think I was once told that 8-12 hours after your body stopped making the ketones, they should return to a normal level, but then your mileage may vary

Dear Kristen. Yes found a box in my medicine cupboard that dates from 2003. They have expired. Probably I did not remember this as I probably never found any ketones. At what concentration of Blood glucose should one start measuring for them? Or what conditions? Is a very low carb diet more conducive to forming them?

I am on a low carb diet,not because I want to but because I can’t eat alot.I find when I fast for my basal testing I have normal bloodugars but trace amounts of ketones.I normally don’t have any.I read that you should drink an 8 oz glass of water each hour to flush them out better.

I was told to test for ketones if your BG is over 13.0 (230), just as a precaution. Also if you have had a high two to three times in a row even after correction boluses.

Kristin, I think it’s normal. If the ketones persist more than 24 hours, I might call a doctor, but sometimes your body just has to right itself. Lots and LOTS of water to continue to flush your system. Once my sugars are down, I normally have trace ketones for a couple of hours. 12 would be pushing it for me, but not unheard of.

Hope you’re feeling better.

Thanks for all the replies!

I have tested negative for ketones ever since. So I think my system is clear.

This was my first experience like this (after 5 years of pumping). I never realized how exhausting it would be. I’m relieved that it’s behind me, but I feel like I just ran a marathon!!

good to hear Kristin, and it can wear you out. Tired from the sugar being high and from getting dehydrated as the ketones get flushed from your system via urination. Frequent urination is a sign of DKA and is what causes a lot of the weight loss newly diagnosed diabetics experience.

But know you know what it is and how it feels when it is coming on!

Good work!


I don’t have your answer … just a couple of questions.

Do T2 diabetics get ketones? I had been without the proper insulin for 2 days around Christmas because of a pharmacy screw-up and went up to 509. The paramedic mentioned something about “flushing ketones” but I really don’t understand it much.

Can ANYONE out there put me straight. I thought that only T1 diabetics had problems with ketones.

Lois La Rose


Spilling ketones is a result of high blood sugar over a period of time. If your sugars are high enough, long enough you will spill ketones regardless of what type of diabetic you are. It is a normal function of your body in response to the high sugar level.

Normally, T1s are the only ones whose sugars get that high, but a T2 who is on insulin could, I imagine.

Ketones happen as a byproduct of your body breaking down muscle and fat in the absence of insulin. Basically, your body doesn’t have enough fuel so it starts breaking itself down. Since ketones are acidic, your blood gets more acidic and can do some really serious damage to your organs and blood vessels (and eventually will kill you). My understanding is that they typically are a problem only for people with a complete insulin deficiency - i.e. type 1, or a type 2 who no longer produces any insulin at all. But, anyone can test positive for ketones if they’re not eating/metabolizing enough carbohydrates to sustain their body. You can also get something called a hyperosmolar nonketotic state, where extremely high blood sugars are worsened by severe dehydration and can quickly lead to death (this usually occurs in type 2 and is pretty rare I think).

glad to hear you got things straightened out! If your pump threw a no delivery alarm overnight I’m guessing you were probably pretty insulin deficient (at least w/ my Minimed pump it takes 5 units of pressure backing up before the alarm goes off, that’s 6 hours worth of basal for me). When this happens to me I’ve noticed that sometimes I need more insulin plus some fast-acting carbs to get rid of the ketones even when my BG drops back down, despite drinking a ton of water. I think maybe a little sugar helps switch the metabolism back over to burning carbs. My favorite trick is to take insulin for 45 carbs or so and down a big glass of juice. Hope you don’t have to deal w/ that anytime soon though!

actually keytone are very NORMAL and can happen anytime your body is burning fat, for example, if you are trying to lose weight you will have trace keytones. If you are on a low carb diet, keytones, if you are exercising, keytones!

Keytones in the absence of insulin can build up quickly to a point where they can become harmful, DKA is a run-away situation where you will probably need blood pH adjustment via IV or you could be very sick, and may in fact die. A failed infusion set can cause this because we pumpers have no long-acting insulin and so in an hour or 2 we can get into troubles. In that case overdoing the water thing is a big, big help. However water helps flush everything out of your body, including beneficial water soluable vitamins, so please don’t over do the hydration thing - drink when thirsty. =) Cheers!

Dear Joe. I remember Dr. Atkins talking about ketones in a low carb context and I think in a positive way. Would it be an idea to try and measure for them to see if you are low carb enough? Keto acidosis does not fun and I think is a different thing to what atkins had in mind , surprised to her that It can occur in some pumpers so fast.

Atkins was looking for medium to high keytones, meaning you are getting a majority of your energy by burning fats, which is what you want if you are trying to lose weight. Normal people make enough insulin so there’s no real danger of medium keytones, it’s a positive feedback. We can have keytones, but there is more danger, especially if high sugar starts that acid runaway reaction

If you don’t have any/enough insulin - your body begins ot burn fat (and muscle) in the presencs of high sugar to survive. keytones and acid, from high sugar, then accumulate uncontrollably, then your sick with DKA. or dead. go carefully.

The ketostix turn purple if there is ketones in your urine. I think they’re cheap.

Dear Joe.

Still slightly confused, so if a normal non-diabetic follows the Atkins diet he will have measurable ketones in the urine as Atkins claims or is it nonsense as they have plenty of insulin and will never form ketones?


anytime anybody burns fat they make keytones. doesn’t matter if you are diabetic or not, so Yes, if you follow a low or zero carb diet your body has no choice but to make keytones.

DKA is not just the keytones.

DKA can happen when you have high keytones + high blood sugar + No Insulin that’s why its called “Diabetic KetoAcidosis” non-diabetics would not be subject to DKA because they make their own insulin