KETONES IN URINE NOT DIABETIC
Most diabetic patients are quite familiar with the word ketones. As their doctors will regularly instruct them to watch your ketone level because excessively high ketone levels would lead to a complication called diabetic ketoacidosis (DKA) which could lead to a diabetic coma or death.
Ketosis is a normal process that occurs during fasting or probably after a low ketogenic or carbohydrate diet. It is a process whereby fats and proteins are burned up by the body as energy.
The energy utilized by the body is gotten from sugar (glucose) which is normally gotten from the carbohydrate diet we eat.
A diet low in carbohydrates (ketogenic diet) or prolonged fasting can cause the body to used fat and protein as energy or fuel. This can lead to the production of ketones.
What are ketones?
Ketones are formed when the body burns fat for energy instead of sugar(glucose). The two ketones formed when fat is burned as energy are acetoacetate and beta-hydroxybutyric acid.
They are usually formed in the liver where they are broken down and are found in little quantities in the urine.
This normal process of ketone production is usually interrupted and influence by certain factors thereby leaving a high level of ketone in the urine, this condition is referred to as ketonuria or acetonuria.
Ketones are acids produced when the body uses fat or protein as fuel. A high level of ketones can cause the normally alkaline blood to become acidic.
Is ketone in urine bad
Ketones in the urine is a normal process that occurs after the intake of a ketogenic diet or prolonged fasting.
Normally ketones are metabolized in the liver, leaving behind only a few amounts of ketones that are found in the urine.
When the body uses up fat in the body as fuel this leads to the production of ketones in the urine.
High level of Ketones in urine is extremely dangerous especially in a diabetic patient as this could lead to diabetic ketoacidosis (DKA).
What causes ketones in urine?
Poorly managed diabetes
Most diabetic patients are regularly instructed by their doctors to watch their ketone level, conduct urine test regularly in order to keep track of their ketone levels but most of them fail. This leads to an increase in the production level of ketones leading to a condition referred to as Diabetic ketoacidosis (DKA).
Fasting or starvation
Extreme fasting for as long as 12 – 15 hours can also lead to the production of ketones as the body uses fat as energy. The waste product released is ketones.
Other causes of Ketones in urine include;
- A ketogenic diet (food low in carbs)
- Excessive alcohol
- Eating and digestive disorder.
- Pregnancy etc.
This condition is also referred to as ketoaciduria and acetonuria. It occurs when there is a high level of ketone bodies in the urine as a result of the low carbohydrate diet or insufficient insulin.
Ketonuria is especially dangerous to diabetic patients as it could lead to a complication known as diabetic ketoacidosis (DKA). Ketonuria can be caused by so many factors including irregularities in diet, fasting, and medications.
Causes of ketonuria
- Ketogenic diet
A diet low in carbohydrates is referred to as a ketogenic diet. Energy is required by the body for efficient cellular function, this energy is usually gotten from carbohydrates but when the intake of carbs is low the body uses fat as a substitute Leading to the production of ketones.
- Insulin Deficiency
Diabetic patients suffer from insulin-related issues such as;
- Insufficient insulin
- Non-production of insulin.
Insulin is a hormone produced by the pancreatic islets that allow the body to utilize the sugar gotten from carbohydrates either for energy or stores them as glucose for future use.
Diabetic patients might have little to no insulin. Hence the body looks for another source of energy (fat). The body cannot properly absorb sugar from carbohydrates without insulin.
- Illness or infections
Certain illness like sepsis, high fever, and urinary tract infections also leads to a high level of ketones in the urine.
Pregnant women who are also diabetic patients are at a very high risk of experiencing ketonuria.
Healthy pregnant women who eat low carbohydrate food and stay hungry along will also experience ketonuria.
Other causes of ketonuria include;
- Excessive consumption of alcohol
- Nausea and vomiting
- Smelly breath(fruity)
- Xerostomia(dry mouth
- Constant urination.
Tests for ketonuria
Acetone breath test
Acetone is produced during fat metabolism, acetone is present in exhalation(exhaled breath).
While testing for ketone using the acetone breath test method, be meticulous as certain can affect the acetone level.
The level of acetone can be affected by the following;
- Rate of respiration
- Lip balm
- Mouth wash
- Time of the day
- Coffee etc.
There are several devices including Ketostat, LEVL, and ketonix that can be used to measure the level of acetone in order to ascertain the ketone level.
Ketonix and ketostat require to set up prior to use, they require a downloaded app in order to connect by Bluetooth to the device.
Once the setup is completed, take a deep exhale from the bottom of the lungs then the device starts measuring up the acetone level.
This test can be carried out privately at home or in the lab.
Urine test at home
A urine strip test is used to carry out the ketones in urine test at home, urine is collected into a clean container and a test strip is dipped into the collection.
The strip test kit comes with a color chart, you should follow the instructions on the strip and compare the color of the strip with the color chart provided.
Precautions at home
- Use the urine test kit recommended by your doctor.
- Obtain a urine test kit from the pharmacy.
- Check the expiration date of the urine test kit before making a purchase.
Urine test in the lab
Hands should be properly washed, urine should be collected in the provided container and handed over to the medical practitioner attending to you.
Note: you might be instructed to embark on a little fast few hours before the test is conducted.
The urine test is used to measure the number of ketones found in the urine. A low level of ketones in urine could be a result of fasting or starvation but a high level of ketones in the urine is a determinant for DKA(diabetic ketoacidosis).
Who should test for ketonuria?
- Diabetic patients
- Pregnant women
When to have a test for ketones in urine?
- Constant fatigue
- Ceaseless dry mouth(xerostomia).
- High blood glucose
- Lack of focus, always confused and disoriented.
- Chronic Abdominal pain
- Excessive vomiting.
The most important thing to note about the treatment process is; the cause ketonuria has many causative factors and if you are able to determine the cause, then the treatment process can be efficiently executed.
The mild case of ketonuria caused by fasting can be treated with a little adjustment to your eating habits.
Other severe cases can be treated by;
- Administration of intravenous fluid.
- The use of electrolytes such as chloride, potassium, and sodium.
Ketonuria gotten illness can be treated with antibiotics and antivirals.
Complication of ketonuria
According to the mayo clinic, ketoacidosis is a serious complication of diabetes that occurs when the body produces a high level of blood acid known as ketones.
The deficiency of insulin leads to hyperglycemia (that is high blood sugar level) and a very high level of ketones in the blood and urine. This condition is known as ketoacidosis.
This is a life-threatening condition, as a high content of the acid is very detrimental to the overall body’s health.
High levels of acid are detrimental to health as they affect the overall functionality of the body. Diabetic ketoacidosis is most common among type 1 diabetes mellitus.
Symptoms of ketoacidosis
- Abdominal pain
- Frequent sleeping
- Dyspnea(difficulty in breathing)
- Excessive vomiting
- Lack of focus
- Frequent urination and thirst
Low level of Ketones in the urine is normal especially during fasting and pregnancy, It could be easily corrected by a little change in diet.
The more severe cases with extremely high ketone levels require immediate medical attention.
Ketoacidosis can lead to death and diabetic coma in a diabetic patient, Diabetic patients should therefore be extremely cautious about their ketones level.