Urine Ketone Test and Children With Diabetes

Topic Overview

Fat is burned for energy when insulin is not in the blood to help sugar (glucose) enter cells. When fat is burned, ketones are released into the bloodstream. Ketones, which exit the body via the urine, can lead to the life-threatening condition diabetic ketoacidosis (DKA).

A child with diabetes needs to have his or her urine tested for ketones at home using tablets or plastic strips.

  • Collect a urine sample in a clean container.
  • Follow the manufacturer's directions on the bottle of test strips or tablets.
  • If either the test strip changes color or the urine changes color when the tablet is dropped into the sample, ketones are present in your child's urine sample. The test results are read as negative to 1+ to 4+ or small to large. If the results of your child's ketone test show that the ketone level in his or her urine is more than 1+ or is moderate to high, call your child's doctor for advice.

All children with type 1 diabetes and those with type 2 diabetes who have a history of having DKA need to test their urine for ketones when they are sick or under stress, when blood sugar levels have been consistently above 300 mg/dL, and when they have symptoms of DKA (nausea, vomiting, or abdominal pain).1



  1. American Diabetes Association (2004). Tests of glycemia in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S91–S93.


Author Caroline Rea, RN, BS, MS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer Stephen LaFranchi, MD - Pediatrics and Pediatric Endocrinology
Last Updated July 28, 2008

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