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.

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