What to Do If You Have Ketones

Patient Expert
Medically Reviewed

I woke up pretty late today, around 11am. I really didn't feel like getting up at all because I was still really tired.

I was woken up by a ringing house phone that I ignored, then a cell phone with my husband on the other end. Then my mom coming downstairs to get the laundry and reminding me that we were going out today. (I live in my parents basement apartment.)

"Ok, Ok... I am getting up" I tell her.

I took in a big yawn and stretch of the arms. Then I actually got up out of my bed. I felt weird but I just thought it was because I got out of the bed too quickly. I tried to lick my lips together, but I had no saliva in my mouth - it was like the Mojave desert in there.

I went to the bathroom to wash up because now my mom was getting antsy and rushing me. Don't you just love getting up like that?

Anyway, I started to feel a bit nauseated after about 20 minutes. I know these symptoms all too well.

Dry mouth, Nausea = High blood sugar or Ketones.

So, I checked my blood sugar.




334. Oh boy.

Ok, umm... how did this happen? I didn't really eat anything high carb last night? I went to bed with a pretty decent number and I just changed my infusion set. I don't feel sick. My pump site isn't hurting. It really boggled my mind.

I felt my heart race a bit and started feeling panicky, and my breathing was getting heavier. Can you say panic attack? I always get a little paranoid though, it's just my thing. Anyway, I told myself "Ok, Gina just calm down, you know what to do." So I did my thing.

I went back into the bathroom and grabbed my Ketostix to check my urine for Ketones. This is something I do when I have an unexpected high blood sugar with nausea.

My urine test came out with Large, the highest level. Ugh. Ketones on the back of the bottle start out with Negative, Trace, Small, Moderate and Large. I had Large, which becomes a dark purple on the urine stick.

You can see what the back of the bottle looks like below.

Note: You can purchase Ketostix at your local drugstore without a prescription; I think they are about $12. There are some other familiar ketone brands like Clinistix, and Keto-Diastix. Using urine ketone strips are very easy. You can urinate directly onto the test strip or you can collect some urine into a paper cup and dip the test strip in directly. The results are pretty much instant. The color changes and will indicate the amount of ketones in your urine. (Image above) You can also test to see if you have ketones by using the Precision Xtra ® meter by Abbott.

What are Ketones?

Ketones are organic compounds produced when your body burns stored fat for energy.

Some situations when you can develop ketones are:

  • If you become sick or ill (especially with an infection)
  • Stress
  • During exercise
  • Insulin pump malfunctions or bad pump sites
  • Having high blood sugars for a long period of time
  • Missing a bolus more than once
  • During pregnancy
  • Pancreatitis
  • Cerebrovascular accident
  • While using some drugs

You should always call your doctor if you have any of the following, along with ketones in your urine. It can be a more life threatening condition called Diabetic Ketoacidosis.

  • Abodomial pain
  • Nausea
  • Vomitting
  • High blood sugars
  • Frequent urination
  • Polydipsia (increased water intake)
  • Dehydration
  • Weight loss
  • Weakness
  • Poor skin turgor
  • Altered respiration
  • Tachycardia
  • Hypotension
  • Mental status change
  • Lethargy
  • Coma

When you do have ketones and you are not vomiting, you should act fast to avoid a hospital trip. (If you are vomitting call your doctor ASAP).

This is what I did.

Right after I knew that I had definitely had ketones and my doctors had told me what to do (your situation may differ though). I immediately took out my pump infusion set because I did not want to take any chances of it being a bad pump site. Then I went and got a syringe, and took a manual correction of 6 units. I did this so that while I was putting in my new pump site, there was already a fast acting insulin going into my system to lower my blood sugar.

After I changed my infusion set, I got a bottle of water from the fridge. When you have ketones it is crucial to drink plenty of liquids to clear out the ketones. I usually try to drink one bottle of water per half hour. This will keep your body from further dehydration. Dehydration can cause ketones as well.

I then called my diabetes team and told them what was going on so that they were aware, just in case my blood sugars didn't go down. They could then advise me on what further steps to take.

I checked my blood sugar every hour after my manual correction to make sure the numbers were coming down. After a couple of hours I was back in range again.


My diabetes team gave me a friendly ring back to make sure I was doing okay. I am so grateful of my team! They're the best.

Today, I acted fast and because of it I was able to get my blood sugars down without an annoying trip to the hospital.

You have to listen to your body, and act quickly. But, just know that sometimes you can do everything right and you may need to go to the hospital because of something else going on out of your control like you coming down with something — or it can be the signs of a serious condition. Never take ketones lightly, remember to always call your doctor if something doesn't feel right.