Every cell in your body needs energy to survive. Most of the time, you create energy from the sugar (glucose) in your bloodstream. Insulin helps regulate glucose levels in the blood and stimulate the absorption of glucose by the cells in your body. If you don’t have enough glucose or insufficient insulin to get the job done, your body will break down fat instead for energy. This supply of fat is an alternative energy source that keeps you from starvation.

When you break down fat, you produce a compound called a ketone body. This process is called ketosis. Insulin is required by your cells in order to use the glucose in your blood, but ketones do not require insulin. The ketones that don’t get used for energy pass through your kidneys and out through your urine.

Ketosis is most likely to occur in people who have diabetes, a condition in which the body produces little or no insulin.

Ketosis and Ketoacidosis: What You Need To Know

Ketosis simply means that your body is producing ketone bodies. You’re burning fat instead of glucose. Ketosis isn’t necessarily harmful to your health. If you don’t have diabetes and you maintain a healthy diet, it’s unlikely to be a problem.

While ketosis itself isn’t particularly dangerous, it’s definitely something to keep an eye on, especially if you have diabetes. Ketosis can be a precursor to ketoacidosis, also known as diabetic ketoacidosis. Ketoacidosis is a condition in which you have both high glucose and high ketone levels. Having ketoacidosis results in your blood becoming too acidic. It’s more common for those with type 1 diabetes rather than type 2. Once symptoms of ketoacidosis begin, they can escalate very quickly. Symptoms include:

  • breath that smells fruity or like nail polish or nail polish remover
  • rapid breathing or shortness of breath
  • excessive thirst
  • frequent urination
  • stomach pain
  • nausea, vomiting
  • fatigue, weakness
  • confusion

If you have ketoacidosis, blood tests will show dangerously high glucose and ketone levels. Urine tests will also reveal high ketone levels. This is a life-threatening medical emergency. Without prompt treatment, ketoacidosis can lead to coma or death.

Ketoacidosis is sometimes one of the first signs that you have diabetes. If you have diabetes, your ketone levels may be high because you aren’t getting enough insulin or you aren’t eating enough. A high ketone level early in the morning may mean you had an insulin reaction while you were sleeping.

Your diet can trigger ketosis. If you’re on a low-carb diet, you’ll have less glucose in your blood and you’ll produce less insulin, so you’ll start burning fat. Fasting and consuming too much alcohol can also lead to ketosis.

Treatment for ketoacidosis usually includes insulin therapy, along with replacing fluids and electrolytes.

Testing For Ketone Bodies

Routine monitoring for ketone bodies may be recommended if you have diabetes, especially if you’re pregnant.

Your doctor can order a blood ketone test. Blood can be taken from a vein in your arm or from a finger stick. Urine tests can also determine ketone levels. But urine tests may not be as accurate because it takes awhile for ketones to pass through your system.

A ketone level under 0.6 mmol/L is generally considered low. A level between 0.6 mmol/L and 1.5 mmol/L is in the mid range. Any reading above this is high. If you have diabetes and your ketones are moderate to high, drink water, avoid exercise, and alert your doctor right away.

Over-the-counter urine ketone testing kits are available. You’ll need to use a dipstick and provide a clean-catch urine sample. The stick will change color to indicate a small, moderate, or large amount of ketones.

If you have diabetes, your doctor can instruct you on how to record your ketone levels. According to the American Diabetes Association, you should probably check your urine if your blood glucose level is over 240 mg/dl. You should also check it every 4-6 hours when you’re feeling sick or if you have any symptoms of ketoacidosis.