What’s a ketone?
In medicine, it’s applied to the chemical acids produced by the body when it has insufficient insulin levels in the blood to metabolise glucose to fuel its cells. If this happens, your body starts to burn up its own fat and, as a result as part of the biochemical reaction needed, ketone bodies will be produced. This is a common complication related to diabetes, particularly in Type 1 or advanced Type 2 diabetes.
How does this happen?
When you don’t get enough insulin, your body can’t transfer glucose from your blood into your cells to use as energy and must look for a replacement. Your liver can convert its fatty acids into ketones, which can be used as an alternative source of energy. Ketones are generally present in your body at a low level because they are produced whenever you burn body fat through exercise. In people with diabetes, excess ketone levels can pose a serious health risk.
Diabetes Ketoacidosis (DKA)
If you are insulin dependent, suffering from Type 1 or advanced Type 2 diabetes, excessive levels of ketones can result from insulin deficiency. If left untreated, a high level of ketones in the bloodstream can lead to a dangerous condition known as ketoacidosis, which causes coma and eventual death. Diabetic ketoacidosis (DKA) can occur during illness or if you take too little insulin, and is determined by high blood glucose and ketones detected in the blood and urine. If you think you might be suffering from an excessive level of ketones, you should contact your doctor or diabetes clinic as soon as possible.
How do I know if I have excess ketones?
The most accurate test for ketone levels is by means of a blood test, which you can perform at home. Some devices allow for testing glucose and ketones in your blood, and other devices could alert you of the potential presence of ketone bodies in your blood. You can also do a urine test, but this is less immediate as it will only register the ketone levels which existed a few hours previously.
Do I need to monitor my ketones?
If you are on insulin or are taking a type of drug called SGLT2 inhibitors (eg Jardiance®, Invokana® or Forxiga®), you might need to monitor your ketone levels and learn to recognise the symptoms of ketoacidosis which might indicate that your diabetes management needs a tweak. Please consult with your diabetologist and/or GP about testing for ketones.
Ketone testing is also important during pregnancy. If you are a person living with diabetes and on insulin, or even if you have gestational diabetes not treated with insulin, you should consult your doctor immediately if you experience any DKA symptoms. These may include dehydration, vomiting, rapid heartbeat, hyperventilation or deep laboured breathing, confusion, disorientation and a smell like pear drops or nail varnish on your breath.