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DKA AND BLOOD KETONE MONITORING

What are blood ketones?

Ketones are the byproduct of fat metabolism. In order to derive energy from the carbohydrates in the foods that we eat, the body needs insulin. In the absence of sufficient insulin, the body begins to metabolize fat and produces ketones.

Ketones can be very dangerous when the blood glucose level is high. If the levels of glucose and ketones in the blood keep rising, one can get very sick very quickly. The person begins to get dehydrated and acidotic: the body loses water and salts, and the pH falls with a buildup of acids, the ketones, developing diabetic ketoacidosis (DKA).

DKA is a dangerous and potentially life-threatening condition, with thousands of episodes each year.
Most episodes of DKA are preventable.

Why check blood ketones?

Checking blood ketones reduces the risk of DKA.
Checking the level of ketones in the blood and reacting promptly with extra insulin, fluids, and communication with the
healthcare team can prevent the need for emergency treatment.

Who is at risk for DKA and would benefit from checking blood ketones?

Type 1 diabetes patients	Children & teenagers	Insulin pump users	Pregnant women	Insulin-treated type 2 diabetes patients

How to interpret blood ketone results?

	Blood ketone levels below 0.6 mmol/L are considered normal. Re-check ketone levels in 1-2 hours if blood glucose remains above 250 mg/dL (13.9 mmol/L).
	Blood ketone levels between 0.6 and 1.5 mmol/L indicate need for extra insulin. It is important to call or follow the indications of the diabetes healthcare team and keep checking blood glucose and ketone levels during the following 1-2 hours.
	Blood ketone levels above 1.5 mmol/L indicate risk of diabetic ketoacidosis. Contact healthcare team IMMEDIATELY.