Were you looking for urine ketones? Urine ketone testing is more common than blood ketone testing and may be performed as part of a urinalysis.
At a Glance
Why Get Tested?
To determine whether excessive ketones are present in the blood, to detect diabetic ketoacidosis
When to Get Tested?
When you have symptoms associated with ketoacidosis
A blood sample drawn from a vein in your arm or from a fingerstick
Test Preparation Needed?
The Test Sample
What is being tested?
This test measures the amount of ketones in the blood. Ketones or ketone bodies are byproducts of fat metabolism. They are produced when glucose is not available to the body's cells as an energy source. When fatty acids are metabolized, ketones build up in the blood, causing first ketosis, and then progressing to ketoacidosis, a form of metabolic acidosis. This condition is most frequently seen with uncontrolled type 1 diabetes and can be a medical emergency.
There are three ketone bodies – acetoacetate, acetone, and beta-hydroxybutyrate, a reduced form of acetoacetate. Beta-hydroxybutyrate is the predominant ketone present in severe diabetic ketoacidosis (DKA). Different ketone tests measure one or more ketone bodies, and their results are not interchangeable.
Blood testing gives a snapshot of the status of ketone accumulation at the time that the sample was collected. Urine ketone testing reflects recent rather than current blood ketones. Urine testing is much more common than blood ketones testing. It may be performed by itself, with a urine glucose test, or as part of a urinalysis. The urine methods measure either acetoacetate or acetoacetate and acetone but do not detect beta-hydroxybutyrate.
Blood ketones may be measured in a laboratory or with a handheld monitor. The laboratory test uses serum, the liquid portion of the blood, and typically measures acetoacetate. Beta-hydroxybutyrate can be ordered as a separate blood test.
When whole blood from a fingerstick is tested for ketones using a handheld monitor, the monitor measures beta-hydroxybutyrate. This test may be performed at a person's bedside in a hospital or emergency room, in a doctor's office, or performed by a person at home.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm or by pricking a finger.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Vorvick, L. (Updated 2011 February 1). Serum ketones test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003498.htm. Accessed December 2012.
Devkota, B. (Updated 2012 October 11). Ketone (Acetone). Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2087982-overview through http://emedicine.medscape.com. Accessed December 2012.
Raghavan, V. et. al. (Updated 2012 January 3). Diabetic Ketoacidosis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/118361-overview through http://emedicine.medscape.com. Accessed December 2012.
Clarke, W., Editor (© 2011). Contemporary Practice in Clinical Chemistry 2nd Edition: AACC Press, Washington, DC. Pp 404.
McPherson, R. and Pincus, M. (© 2011). Henry's Clinical Diagnosis and Management by Laboratory Methods 22nd Edition: Elsevier Saunders, Philadelphia, PA. Pg 218.
Sources Used in Previous Reviews
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 972-973.
Hurd, R. (Updated 2007 October 31). Serum ketones. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003498.htm. Accessed February 2009.
Holt, E. (Updated 2008 June 17). Diabetic Ketoacidosis MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm. Accessed February 2009.
Mayo Clinic Staff (2008 February 9). Diabetic ketoacidosis. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/diabetic-ketoacidosis/DS00674/DSECTION=all&METHOD=print through http://www.mayoclinic.com. Accessed February 2009.
Hamdy, O. (Updated 2008 July 14). Diabetic Ketoacidosis eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/118361-overview through http://emedicine.medscape.com. Accessed February 2009.
Trachtenbarg, D. (2005 May 1). Diabetic Ketoacidosis. American Family Physician [On-line information]. Available online at http://www.aafp.org/afp/20050501/1705.html through http://www.aafp.org. Accessed February 2009.
Sheikh-Ali, M. et. al. (2008 January). Can Serum _-Hydroxybutyrate Be Used to Diagnose Diabetic Ketoacidosis? Diabetes Care 31:643-647, 2008 [On-line information]. Available online at http://care.diabetesjournals.org/cgi/content/full/31/4/643 through http://care.diabetesjournals.org. Accessed February 2009.
Rose, K. and Collins, K. (2008 December 1). Vitreous Postmortem Chemical Analysis. CAP NewsPath [On-line information]. Available online through http://www.cap.org. Accessed February 2009.
(Updated 2008 December 30). Siezures and Epilepsy, Hope Through Research. NINDS [On-line information]. Available online at http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm through http://www.ninds.nih.gov. Accessed February 2009.
Rho, J. (Updated 2009 February 19). The Ketogenic Diet in Pediatric Epilepsy. The Charlie Foundation [On-line information]. Available online at http://www.charliefoundation.org/frames/diet/overview.php through http://www.charliefoundation.org. Accessed February 2009.
(2006 July). Answering your questions, Serum acetone testing. [On-line information]. PDF available for download at http://www.mlo-online.com/articles/0706/0706tips%20.pdf through http://www.mlo-online.com. Accessed February 2009.
(Modified 2008 August 11). Ketone Testing. Children’s Physician Network [On-line information]. Available online at http://www.cpnonline.org/CRS/CRS/pa_ketone_pep.htm through http://www.cpnonline.org. Accessed February 2009.
Wallace, T. and Matthews, D. (2004). Recent advances in the monitoring and management of diabetic ketoacidosis. QJM 2004 97(12):773-780. Available online at http://qjmed.oxfordjournals.org/cgi/content/full/97/12/773 through http://qjmed.oxfordjournals.org. Accessed February 2009.