Blood Ketones Test

Blood Ketone Test measures the level of ketones present in the blood. Ketones are substances produced by the body when there is an inadequate supply of glucose, which is the main energy source of the body. At these times, fat is used as a fuel. The metabolism of fat gives rise to ketone bodies in the blood. This condition is most commonly seen with people suffering from type 1 diabetes, further giving rise to a condition known as Diabetic Ketoacidosis (DKA). However, type 2 diabetes is also capable of causing DKA.

DKA leads to severe insulin deficiency, a high blood glucose level, and disruption of the acid–base balance of the body. Symptoms of excessive ketones in the blood are dehydration, shortness of breath, nausea, vomiting, fruity scent of the breath, confusion, and ultimately coma.

Ketone bodies are of three different types: beta-hydroxybutyrate, acetoacetate, and acetone. Among them, beta-hydroxybutyrate makes up 75 per cent of the total ketones. Different Blood Ketone Tests measure the presence of different ketone bodies in the blood.

Apart from the Blood Ketone Test, Urine Ketone Tests can also be performed. The Blood Ketone Test helps to indicate the current state of ketone accumulation in the blood, while the urine tests help to indicate the recent state of ketone accumulation in the blood.

Blood Ketone Tests are mostly prescribed to patients who have diabetes along with symptoms of DKA. It is also recommended to sick or pregnant individuals who can develop DKA.

The incidence of DKA is quite common in India. DKA mostly affects infants, children, and individuals who are less than 24 years of age. DKA is found to affect 15 to 70 per cent of children and infants with diabetes. The overall mortality associated with DKA ranges from 4 to 10 per cent.

Coma, kidney damage, brain swelling

The Blood Ketone Test detects the presence of ketone bodies in the blood that can lead to ketosis, ketoacidosis and finally, DKA in individuals with diabetes. The test is also prescribed for pregnant and sick individuals who can develop DKA. Due to the presence of home kits, the test can be carried out quite frequently to monitor the levels of the ketone bodies.

People having certain symptoms of ketoacidosis are prescribed the test by healthcare professionals. These symptoms include

• Excessive thirst along with dehydration.
• Frequent urination.
• Shortness of breath and rapid breathing.
• Rapid heart rate.
• Cold hands and feet.
• Fatigue, nausea, and vomiting.
• Confusion.
• Coma (in extreme cases).

The blood ketone test is also prescribed by doctors if:

• The individual has symptoms of ketoacidosis such as fatigue and fruity breath.
• The individual has an infection or is sick.
• The individual has high blood glucose levels above 240 mg/dL.
• The individual drinks excessive alcohol but does not consume enough food.

A Blood Ketone Test is not a routine test. Doctors may prescribe these tests when you have type 1 or type 2 diabetes. Accumulation of ketones in the blood is more common in the case of type 1 rather than type 2 diabetes.

Patients having symptoms of DKA are also prescribed the test, along with sick or pregnant individuals who are at the risk of developing DKA.

Before the Test

Before undergoing the Blood Ketone Test, it is unlikely that your doctor will require you to take any special precautions. However, if you are to take this test with another one that requires special preparation, your doctor may suggest fasting for a specific time. Always speak with your doctor before a test.

During the Test

For the Blood Ketone Test, the phlebotomist will take a blood sample from your arm. Here's what will happen during the test:

• The likely puncture site will be sterilised with antiseptic.
• A tourniquet will be secured around your arm to make your veins stand out.
• A needle will be inserted into a chosen vein to draw the blood. This may cause a brief pinch for a few seconds.
• The blood will be collected in a vial/small test tube, and a label will be affixed with your details.

After the Test

Following the blood collection:

• A bandage will be placed over the insertion site to stem any bleeding.
• Bruising can happen. If you feel lightheaded (an uncommon side effect), you may be advised to rest for a few minutes.
• In case of persistent bleeding, pain, or rashes at the puncture site, contact your doctor.

The Blood Ketone Test measures the presence of ketones in the blood. The ketones are of three main types: Beta-hydroxybutyrate, Acetoacetate, and Acetone. Different Blood Ketone Tests are required to indicate the levels of different ketone bodies.

These three parameters give an idea about the level of ketone accumulation in the blood, which further indicates the level of blood glucose and the occurrence of diabetes in the tested individuals.

The presence of higher levels of ketone in the blood is common among: 

• People on a low carbohydrate diet.
• People who are addicted to alcohol.
• People who have eating disorders.
• People who are constantly vomiting.
• People who have diabetes, especially type 1 diabetes.

The normal values and reference ranges of the test may vary from lab to lab. Please refer to the ranges mentioned in the report and consult a doctor to understand the interpretation of lab reports.

Blood Ketone Tests, therefore, measure the level of ketone accumulation in the blood. Ketone accumulation in the blood can be quite harmful and lead to ketosis, ketoacidosis, as well as DKA. Individual tests are available to measure the levels of the three different ketone bodies.

A positive Blood Ketone Test result is indicated by a higher quantity of serum ketone levels above 3.0 mmol/dL. Individuals who test positive for this test are at a high risk of developing DKA. At the same time, individuals who test negative for the test have normal ketone levels in the blood.

Individuals with higher levels of blood ketones must immediately consult their doctor as high ketone levels can lead to life-threatening conditions, and coma is not treated immediately.