Ketone Testing

Ketone testing can be done at home
Ketone testing can be done at home

Ketone testing is crucial if you have sustained high blood sugar readings which can often occur if you are ill or you are struggling to keep on top of your diabetes.

If your blood sugar is high, it is an indication that you do not have enough insulin in your system (or that the insulin that you do have is not working effectively).

There’s a chance that your body will start breaking down protein in order to get some energy.

Although your blood is sugary, the cells in your body are not able to use that energy (you need insulin to let the energy in the form of glucose into the cells).

Why are ketones produced?

Ketones are made when the body breaks down proteins. Short-term, this is a way the body has of dealing with a situation where it has no other way to gain energy to keep going. 

But long term, ketones can build up.

This can be damaging, and is referred to as a state of ketoacidosis, or in diabetes, DKA - specifically Diabetic Ketoacidosis.

Where can I get ketone testing kits and sensors?

Some meters have the ability to test ketones, for which you can buy ketone strips (or sensors).

You can also test ketones in your urine.

Ketones affect your diabetes

You need to know about ketones as, a bit like having a hypo, you will feel bad and your judgment of how to handle your diabetes will become impaired.

Ketone Test Meters
Abbott Optium Xceed
The Xceed tests blood glucose and blood ketones. Comes with 10 lancets and 10 test strips and carrying case.
Ketone Test Strips
Abbott Optium Xceed Ketone Strips
Comes in packs of 10 ketone strips only for the Abbott Optium Xceed.
GlucoMen LX Plus Ketone Strips
Comes in packs of 10 ketone strips only for the GlucoMen LX Plus.
Urine Ketone Strips
Accu-Chek Ketur
Comes with 50 strips to test for ketones in the urine. Also known as Ketur Test Reagent Strips for Urinalysis
Bayer Keto-Diastix
Reagent Strips for Urinalysis. The Keto-Diastix from Bayer contain 50 strips to test for glucose and ketones in the urine.
Bayer Ketostix
Bayer's Ketostix contains 50 strips to test for ketones in the urine.

How do you test for ketones?

Historically, ketones could only be tested for in a hospital. Now you can get a few home products that can show ketones. Some blood test meters can also test for ketones in a similar way to blood glucose testing.

What should the ketone test results be?

  • Under 0.6 mmol/L - a normal blood ketone value
  • 0.6 to 1.5 mmol/L - indicates that more ketones are being produced than normal, test again later to see if the value has lowered
  • 1.6 to 3.0 mmol/L - a high level of ketones and could present a risk of ketoacidosis. It is advisable to contact your healthcare team for advice.
  • Above 3.0 mmol/L - a dangerous level of ketones which will require immediate medical care.

Testing for ketones is relevant for people with type 1 diabetes.

In type 1 diabetes, a lack of insulin can lead to higher levels of ketones which in turn could lead to a dangerous state called ketoacidosis.

Diabetes UK recommends people with type 1 diabetes test for ketones if blood glucose levels become high - usually above 15 mmol/L.

Testing for ketones in this way can help you to get advice and treatment before the level of ketones becomes dangerous.

There are two different ways to test for ketones. The traditional way has been to use urine ketone testing strips. More recently though, some blood glucose meters have also been developed that can test the blood for ketones.

A blood test for ketones is similar to how you would do a blood glucose test.

The following ketone testing advice is based on the recommended process for using Bayer Ketostix.

  1. Before testing, check the expiry date on the tub to ensure the strips are good for use
  2. Remove a strip from the tub, taking care not to touch the spongy end of the strip
  3. Pass urine over the test area of the strip or, alternatively, collect urine in a container and then dip the test area of the strip into the urine
  4. Begin timing immediately after applying urine - the strip will begin to change colour
  5. After 15 seconds, compare the colour of the test area to the colour chart on the side of the tub of strips
  6. Disregard any colour changes that might happen after 15 seconds has passed

If blood glucose and ketone levels do not decrease after two tests contact your health team for advice. Bayer provides the following advice for management of ketone levels:

  • A level below 0.5 mmol/L
    This is a trace level of ketones - no action is needed
  • Around 1.5 mmol/L
    This indicates that ketone levels are slightly higher than normal.
  • It’s recommended to drink a glass of water each hour and perform a follow up test 3 to 4 hours later to see if the ketone level has decreased or not.
  • Around or above 3.0 mmol/L
    This is a higher reading. Contact your health team immediately for advice.

Ketone testing strips and meters


Bayer’s Ketostix are available over the counter at pharmacies as well as on prescription. These are bottles of urine reagent strips - dip into urine and see the reactive patch on the end of the stick change colour and compare it with the table provided to see if your body is showing the presence of ketones.

Acon urine reagent ketone

Another brand is Acon which does a bottle of urine reagent ketone and glucose test strips. Talk to your doctor or pharmacist if you think it might be helpful for you to keep a bottle of them handy.

Meters that test for ketones

More accurate readings can come from the Abbott Xceed meter which as well as testing blood glucose levels can also test for ketones and give an actual number (rather than a broader colour reaction).

You need separate test strips for glucose and for ketones, but just the one meter.

Not all diabetics need to test for ketones, but it’s worth having a chat with our doctor so that you understand how to make that judgment for yourself.

Testing for ketones at home

If you do test for ketones when you are at home, should you keep getting high blood sugar readings tests that show positive for ketones then call for medical advice.

Diabetics on insulin should be taking insulin to bring down high blood sugars but keep testing all the time as sugars can go down suddenly once enough insulin has been introduced.