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Home > Knowledge & support > Managing type 1 diabetes > Guide to type 1 diabetes technology > Blood glucose meters > Blood ketone monitoring
Ketones are produced when the body doesn’t have enough insulin to use glucose as a source of energy, so it starts breaking down fat as another way to make energy.
Small amounts of ketone are generally harmless to the body, but too many ketones are dangerous and can cause the body to become too acidic, which can be life-threatening.
If ketone levels build up they can cause the body to become more acidic. This can make you feel very unwell and can lead to diabetic ketoacidosis (DKA). DKA is a serious condition which needs immediate medical attention. Read more about DKA and how to identify, treat and prevent it.
Ketones build up when the body doesn’t have enough insulin to convert glucose to energy. This doesn’t happen most of the time, because people with type 1 learn how to balance their blood glucose levels with how much insulin they’re taking.
However, there are times when you may need more insulin than you usually do. For example, if you’re ill, your body releases stress hormones which can trigger a release of blood glucose stored in your liver. This means you will need more insulin than usual. Stress, not surprisingly, also releases stress hormones which can have the same effect.
Not taking insulin, or enough of it, can lead to a build up of ketones. Lots of people go through periods where they find type 1 difficult, so if you feel like this, you’re not alone. Speak to your Diabetes Healthcare Team, friends, family, online communities, or contact us at outreach@jdrf.org.uk
A blood ketone meter measures the ketones in your blood, in the same way that a blood glucose meter measures glucose. In fact, blood ketone meters and blood glucose meters look very similar and are often combined into one device. They are just measuring different things.
You can get a ketone meter through your Diabetes Healthcare Team clinic or GP. If you’re refused one from your GP because of the cost, ask your hospital-based Diabetes Healthcare Team to write to your GP to request a prescription.
Meters available in the UK, with ketone test strips on prescription, include GlucoMen Areo 2k, FreeStyle Optium Neo and CareSens Dual.
You should test your ketone levels if your blood glucose levels are above 11mmol/L.
If you have any symptoms of DKA you will need to test your ketone levels – or have them tested – as quickly as possible. If you don’t have access to a ketone monitor immediately, go to the hospital straight away.
You should also check your ketones regularly if you are ill. Find out more about how to manage type 1 when you’re unwell.
Lower than 0.6 is a normal reading for blood ketones.
0.6 to 1.5mmol/L means you’re at a slightly increased risk of DKA and you should test again in two hours.
1.6 to 2.9mmol/L means you’re at an increased risk of DKA and should contact your Diabetes Healthcare Team or GP as soon as possible.
3mmol/L or above means you may be in DKA and should get medical help immediately.
There are kits available that test the level of ketone through urine instead of blood. However, this is not as accurate at blood ketone testing. This is because ketones get to the blood before they get to the urine, so a blood ketone test will show you what’s happening more quickly than one that tests your urine. This is important because high ketone levels need to be treated quickly.
Learn more about diabetic ketoacidosis (DKA) and how to prevent it
Find out more about complications and what you can do to help reduce your risk.
Read more about how flash glucose monitoring can help you manage your glucose levels
A smart insulin pen is a reusable self-injection pen, which records information about how much insulin you inject and the timing of it.
Blood glucose meters measure the amount of glucose in the blood. They are an important part of managing your blood glucose levels.
Continuous glucose monitoring can help you manage your glucose levels in real-time and relieve the burden of having to do multiple finger prick tests throughout the day.
A flash glucose monitor is a small wearable device that you scan with a reader or mobile phone to check your glucose levels.
Hybrid closed loop technology – also known as the artificial pancreas – automates many of the decisions that you have to make on a daily basis when you have type 1 diabetes.
Open source and DIY systems are sometimes used by people with type 1 diabetes or people caring for someone with type 1 to help manage the condition.
Apps can help you manage type 1 diabetes, from logging your insulin doses, glucose levels and the food you eat, to helping you count carbs and order prescriptions.
