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Ketones in Blood

What is a ketones in blood test?

A ketones in blood test measures the level of ketones in your blood. Ketones are toxic substances that your body makes if your cells don't get enough glucose (blood sugar). Glucose is your body's main source of energy.

Ketones can show up in blood or urine. High ketone levels may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in blood test can prompt you to get treatment before a medical emergency occurs.

Other names: Ketone bodies (blood), serum ketones, beta-hydroxybutyric acid, acetoacetate

What is it used for?

A ketones in blood test is mostly used to check for diabetic ketoacidosis (DKA) in people with diabetes. DKA can affect anyone with diabetes, but it is most common for people with type 1 diabetes. If you have type 1 diabetes, your body does not make any insulin, the hormone that controls the amount of glucose in your blood. People with type 2 diabetes can make insulin, but their bodies don't use it properly.

Why do I need a ketones in blood test?

You may need a ketones in blood test if you have diabetes and symptoms of DKA. DKA symptoms include:

  • Excessive thirst
  • Increased urination
  • Nausea and vomiting
  • Dry or flushed skin
  • Shortness of breath
  • Fruity smell on breath
  • Fatigue
  • Confusion

What happens during a ketones in blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

You may also be able to use an at-home kit to test for ketones in blood. While instructions may vary, your kit will include some kind of device for you to prick your finger. You will use this to collect a drop of blood for testing. Read the kit instructions carefully, and talk to your health care provider to make sure you collect and test your blood correctly.

Your health care provider may order a ketones in urine test in addition to or instead of a ketones in blood test to check for diabetic ketoacidosis. He or she may also want to check your A1c levels and blood glucose levels to help monitor your diabetes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a ketones in blood test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

A normal test result is negative. This means no ketones were found in your blood. If high blood ketone levels are found, it may mean you have diabetic ketoacidosis (DKA). If you have DKA, your health care provider will provide or recommend treatment, which may involve going to the hospital.

Other conditions can cause you to test positive for blood ketones. These include:

  • Eating disorders, malnutrition, and other conditions where the body does not take in enough calories
  • Pregnancy. Sometimes pregnant women will develop blood ketones. If high levels are found, it can mean gestational diabetes, a type of diabetes that only affects pregnant women.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a ketones in blood test?

Some people use at-home kits to test for ketones if they are on a ketogenic or "keto" diet. A keto diet is type of weight-loss plan that causes a healthy person's body to make ketones. Be sure to talk to your health care provider before going on a keto diet.

References

  1. American Diabetes Association [Internet]. Arlington (VA): American Diabetes Association; c1995–2018. DKA (Ketoacidosis) & Ketones [updated 2015 Mar 18; cited 2018 Jan 9]; [about 3 screens]. Available from:
  2. Joslin Diabetes Center [Internet]. Boston: Joslin Diabetes Center; c2018. Ketone Testing: What You Need to Know [cited 2018 Jan 9]; [about 3 screens]. Available from:
  3. Lab Tests Online [Internet]. American Association for Clinical Chemistry; c2001–2018. Blood Ketones [updated 2018 Jan 9; cited 2018 Jan 9]; [about 2 screens]. Available from:
  4. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Diabetic Coma: Overview; 2015 May 22 [cited 2018 Jan 9]; [about 2 screens]. Available from:
  5. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests [cited 2018 Jan 9]; [about 3 screens]. Available from:
  6. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What is Diabetes?; 2016 Nov [cited 2018 Jan 9]; [about 4 screens]. Available from:
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Diabetes Mellitus (DM) in Children and Adolescents [cited 2018 Jan 9]; [about 2 screens]. Available from:
  8. Paoli A. Ketogenic Diet for Obesity: Friend or Foe? Int J Environ Res Public Health [Internet]. 2014 Feb 19 [cited 2018 Feb 22]; 11(2): 2092-2107. Available from:
  9. Scribd [Internet]. Scribd; c2018. Ketosis: What is ketosis? [updated 2017 Mar 21; cited 2018 Feb 22]; [about 2 screens]. Available from:
  10. UCSF Medical Center [Internet]. San Francisco (CA): The Regents of the University of California; c2002–2018. Medical Tests: Serum Ketones [cited 2018 Jan 9]; [about 5 screens]. Available from:
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Ketone Bodies (Blood) [cited 2018 Jan 9]; [about 2 screens]. Available from:
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Home Blood Glucose Test: How It Is Done [updated 2017 Mar 13; cited 2018 Jan 9]; [about 5 screens]. Available from:
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Ketones: How It Is Done [updated 2017 Mar 13; cited 2018 Jan 9]; [about 5 screens]. Available from:
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Ketones: Results [updated 2017 Mar 13; cited 2018 Jan 9]; [about 8 screens]. Available from:
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Ketones: Test Overview [updated 2017 Mar 13; cited 2018 Jan 9]; [about 2 screens]. Available from:

The medical information provided is for informational purposes only, and is not to be used as a substitute for professional medical advice, diagnosis or treatment. Please contact your health care provider with questions you may have regarding medical conditions or the interpretation of test results.

In the event of a medical emergency, call 911 immediately.