To determine the amount of ketones (ketone bodies, acetoacetate, beta-hydroxybutyrate, and acetone) in your blood to help diagnose life-threatening problems such as diabetic ketoacidosis (DKA) or alcoholic ketoacidosis (AKA)
Blood Ketones
When you have symptoms associated with ketoacidosis, such as increased urination, excessive thirst, dehydration, rapid breathing, and shortness of breath
A blood sample drawn from a vein in your arm or from a fingerstick
None
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How is the test used?
Blood ketones are primarily used to screen for, detect, and monitor a serious, sometimes life-threatening condition called diabetic ketoacidosis (DKA) in people with type 1 and sometimes type 2 diabetes. DKA can occur if you have diabetes and your blood glucose is significantly increased, you are ill or pregnant, have a severe infection, or a variety of other conditions.
Blood ketones are sometimes used, along with other tests such as blood gases, glucose, and electrolytes, to detect ketoacidosis in people without diabetes if they have signs and symptoms of DKA due to, for example, drinking excessive amounts of alcohol.
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When is it ordered?
Blood ketone tests may be ordered if you have diabetes and have symptoms associated with diabetic ketoacidosis (DKA) and may also be performed whenever there is the potential for DKA to develop, such as when you are sick or pregnant. With the availability of home monitoring, blood ketones can be ordered as frequently as your healthcare provider recommends. Some signs and symptoms of ketoacidosis include:
- Having to urinate more often, excessive thirst
- Dehydration
- Dry skin, cold hands and feet
- Rapid breathing, shortness of breath
- Rapid heart rate
- Fruity scent to the breath
- Nausea, vomiting, sweating
- Fatigue
- Confusion
- Coma (sometimes)
In people who do not have diabetes, blood ketones are usually ordered when someone has symptoms associated with ketosis or ketoacidosis, such as those with alcoholic ketoacidosis (AKA) or prolonged starvation.
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What does the test result mean?
If blood ketone levels are increased, then you have some degree of ketosis or ketoacidosis.
If levels are low or normal, then you either do not have excess ketone production or the ketone body that is elevated is not being detected by the test method used.
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If I have diabetes, can I just test for glucose instead of ketones?
They are related but not the same thing. While increases in ketones are associated with high glucose concentrations, they can also occur with moderate glucose levels in many conditions, such as when you are sick.
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Can I test for ketones in my urine instead of my blood?
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Can I get diabetic ketoacidosis if I have type 2 diabetes?
Yes, although it is not as common as in type 1 diabetes. It may occur in type 2 diabetes, especially when you have a severe infection or illness. Ketosis and ketoacidosis may also be seen in people without diabetes, such as people with prolonged starvation, alcoholism, and with high-fat, low-carbohydrate diets (keto diets). It may be induced on purpose in some children with epilepsy who have frequent seizures and do not respond to available medications or other treatments.
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Can I have ketosis or ketoacidosis and not know it?
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Is there anything else I should know?
Recent studies have shown that serum ketones and beta-hydroxybutyrate testing are both effective in diagnosing diabetic ketoacidosis (DKA). Some healthcare practitioners prefer beta-hydroxybutyrate. In acute DKA, the ketone body ratio (beta-hydroxybutyrate:acetoacetate) rises from normal (1:1) to as high as 10:1. In response to insulin therapy, beta-hydroxybutyrate levels commonly decrease long before acetoacetate levels. However, beta-hydroxybutyrate is not available in all laboratories.