Isn’t diabetes a disease of glucose? Yes it is, but keeping glucose in the blood, and thus away from the cells of the body has consequences. Without glucose, cells start relying on alternative sources of energy.
Why do cells produce ketones in diabetes?
When there is lack of insulin or whether the cells of the body are unable to respond to insulin, the cells rely on breaking down proteins and fatty acids. Fatty acid metabolism yields ketones, also called ‘ketone bodies’. When ketones are released into the blood (and ultimately in urine), we call that “ketosis”. In severe cases of ketosis due to diabetes, the patient can suffer diabetic ketoacidosis, which is a medical emergency.
Other causes of ketosis and ketones in urine
- Starvation, strict dieting, low carb/high fat diet, anorexia nervosa, bulimia
- Alcohol abuse
- Severe stress
- Severe exercise
- Exposure to cold
- Nausea and vomiting (causing loss of carbohydrates)
- Severe fever due to infection
When to measure urine ketones?
The American Diabetes Association recommends a diabetic to test for ketones in urine if he/she has a blood glucose level above 300 mg/dL. Nausea, vomiting and abdominal pain are also red flags supporting an immediate urine ketone measurement, as they are the typical presentation of diabetic ketoacidosis (DKA). The patient should also check urine ketones in case of stress, feeling of sickness and pregnancy. You can measure ketones at home with test strips.
Prevention
As a medical doctor in training, I can’t emphasize enough the importance of a healthy lifestyle that can keep you away from life-threatening complications of diabetes! There is no magic pill, but lifestyle change can work magic. I strongly encourage you to challenge your diabetes by treating your body the right way!
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