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Ketones in Urine – During Pregnancy, Diabetes

Updated on November 4, 2013

The body generally uses carbohydrates and sugars to produce energy for varied bodily functions. Sometimes, it may metabolize fat to make energy. This abnormal process results in the formation of a by-product called ketones which are then eliminated via urine.

Ketones in urine can arise due to intake of high-protein diets or low amounts of carbohydrate-rich foods. Reduced carbohydrate intake can also occur during starvation. The lack of adequate carbohydrate content in the body prompts the body to look for alternate sources of energy. This is when it metabolizes fat, which eventually results in ketones in urine. The presence of anomalies or diseases in the body which prevent the efficient use of carbohydrates as a source of energy may also cause the body to metabolize fat, leading to ketones in urine.

Urine normally does not have any ketone composition. The presence of ketones in urine ranging between 0 to 160 mg/dl is considered as abnormal.

Symptoms of ketones in urine

The signs and symptoms of ketones in urine may vary in different individuals as discussed below.

In Diabetic Patients

When individuals affected by diabetes exhibit ketones in urine, then it is most likely to be caused due to reduced insulin content in the body. Along with ketones in urine, diabetics may suffer from the following symptoms:

  • Elevated levels of blood sugar which can be 300 mg/dL of blood, or more.
  • Occurrence of diabetic ketoacidosis along with its symptoms like vomiting, fatigue, nausea, etc.
  • Increased stress
  • Abdominal pain
  • Malaise or sickness

In Pregnant Women

  • The occurrence of ketones in urine at the time of pregnancy indicates that the pregnant woman may be suffering from gestational diabetes. This condition can be harmful for the developing fetus and hence requires immediate medical attention.
  • It may be noted that low levels of ketones in urine along with other symptoms like nausea and vomiting are common in pregnant women. However, excessive quantities of ketones in urine can result in a variety of problems during pregnancy. The best option is to go for regular checkups during pregnancy so as to prevent and control varied abnormalities, including elevated ketone levels in urine.

Causes of ketones in urine

Ketones in urine may occur due to a variety of causes as listed below:

  • The use of fats by the body in place of carbohydrates to make energy. This can occur due to presence of varied health problems.
  • Starvation or fasting, wherein a person does not eat food for 18 hours or more
  • Adherence to a strict diet plan
  • Engaging in extreme physical activities or exercises
  • Following a low-carbohydrate or high-fat diet
  • Excessive alcohol intake, or poisoning caused due to intake or topical use of isopropanol or medicated alcohol
  • Poor nutrition caused due to underlying presence of anorexia nervosa, bulimia, or other eating disorders
  • Elevated contact with cold environments
  • Loss of carbohydrates from the body due to chronic nausea or vomiting
  • Occurrence of diabetic ketoacidosis or poorly managed diabetes
  • Infections that cause high fevers
  • Insulin overdose

It is important to remember that ketones are acidic in nature and hence very hazardous if they are allowed to buildup in the body. People who fast will initially elicit a gradual rise in the levels of ketones in urine, which is later followed by an increase in the blood ketone content.

Diagnosis of ketones in urine

The procedures for verifying ketones in urine differ from the normal diagnostic tests for sugar urine levels. Individuals may use the special ketone sticks or consult a doctor to test the levels of ketones in urine.

The morning urine sample should be used for testing the ketone levels. This is because we do not eat all through the night whilst sleeping, which can then cause the body to burn fat and produce energy, thereby leading to ketones in urine.

Treatment of ketones in urine

  • Treatment of ketones in urine is aimed at finding out the exact cause of the excessive ketone content and then treating those underlying disorders.
  • Pregnant women and diabetic individuals are more likely to experience dangerous reactions of ketones in urine. Hence such people may need to be hospitalized so as to stabilize the ketone levels in urine.

It is possible to prevent instances of ketones in urine by following the below listed precautionary guidelines:

  • Do not skip any meals. Avoid long gaps between meals
  • Pregnant women should eat food after a gap of every 3 to 4 hours
  • You may eat a starchy and protein-rich snack before going to bed. The proteins will slow down the processing of carbohydrates by the body. This in turn permits energy to stay for longer durations in the body
  • Avoid sleeping for more than 9 to 10 hours. If you do have to sleep longer, then it is best to get up and take an enriching snack and then go back to sleep. Such practices will lower the chances of fat metabolism and subsequently ketones in urine.


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