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Ketone Blood Testing


Updated July 14, 2010

Ketone Blood Testing:

Ketone blood testing has been the gold standard for assessing the presence of ketones for several years. Ketones occur when your body is starved for insulin and burns body fat as an alternative source of fuel. Burning fat in this way produces a toxic byproduct that can lead to ketoacidosis or even death if not treated in time.

Prior to the establishment of blood ketone testing, the only method available was to test the urine for ketones. As ketones build up in the blood, they eventually spill into the urine. A chemically treated strip can be used to test the urine sample for the presence of ketones. These strips are still widely used.

But the question lingers: why is blood ketone testing preferable?

Why Blood Ketone Testing?

In hospitals, one of the main advantages of using a blood ketone test is that it provides the current status of the ketones, whereas the urine sample may be hours old.

Urine strips are also less appealing because they degrade over time, which means they lose their ability to be accurate after about 6 months. This means the strips must be replenished on a regular basis. In addition, if the urine strips have often been exposed to the air, or the urine specimen is highly acidic (high doses of vitamin C, for example) or combined with the use of certain prescription drugs, the strips can give a false-negative reading.

Urine testing cannot provide as precise an identification of ketones as testing the blood can. The urine strips merely change color and represent a range of possible ketone activity when they come in contact with the urine sample. In contrast, the blood ketone tests give a specific number that can more accurately assess the level of ketones and the appropriate treatment that is needed.


The Importance of Blood Ketone Testing in Diabetes Management. Managed Care. Accessed June 16, 2010. http://www.managedcaremag.com/supplements/0404_ketonetesting/MC0404_ketonetesting.pdf

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