Ketone Checks Diabetes: What You Need to Know About Testing and Management

When you have diabetes, a condition where the body can't properly use blood sugar for energy. Also known as hyperglycemia, it can lead to your body breaking down fat for fuel — a process that produces ketones, acidic chemicals that build up when insulin is too low. If ketones get too high, you risk diabetic ketoacidosis, a life-threatening condition that needs immediate treatment.

Not every person with diabetes needs to check ketones daily. But if your blood sugar stays above 240 mg/dL for hours, you're sick, vomiting, or feeling unusually tired, it's time to test. You can check ketones with a simple blood ketone test, using a meter similar to a glucose monitor, or with a urine ketone test, using strips you dip in a urine sample. Blood tests are more accurate and give real-time results — urine tests show ketones from a few hours ago, so they’re less reliable when things are changing fast.

High ketones don’t always mean you’re in danger. Some people on low-carb diets have mild ketosis without any risk. But for someone with type 1 diabetes — or even type 2 diabetes on insulin — rising ketones with high blood sugar is a red flag. It means your body isn’t getting insulin where it’s needed. That’s when you call your doctor, drink water, and possibly adjust your insulin dose under guidance. Skipping insulin because you’re sick? That’s when ketoacidosis sneaks up.

Many people don’t realize how quickly things can go wrong. A study in the Journal of Diabetes Science and Technology found that over 60% of diabetic ketoacidosis cases in young adults happened because they stopped insulin during illness — not because they forgot to take it, but because they thought they didn’t need it when they weren’t eating. That’s a myth. Your body still needs insulin even if you’re not eating carbs. Ketone checks are your early warning system.

You don’t need to test every day. But if you’ve had high blood sugar before, if you’re new to insulin, or if you’ve ever had ketoacidosis before, keep test strips on hand. Keep a log. Note your blood sugar, ketone level, symptoms, and what you did next. That pattern helps you and your doctor spot trouble before it becomes an emergency.

What you’ll find in the posts below are real, practical stories and science-backed advice on how ketone checks fit into daily diabetes care. You’ll see how people manage ketones during illness, how to interpret test results without panic, and what to do when your ketones rise. There’s no fluff — just clear, direct help from people who’ve been there and experts who’ve studied it.