Ketones with Normal Blood Sugars?!

I have no idea what is going on with me and unfortunately my doctor is of little to no assistance right now. Lately, I have had this thing going on where I have small-moderate levels of ketones with normal blood sugar readings. I don't usually feel sick either. I will check when I have some symptoms, fruity breath etc. I check my ketones with ketostix.

Tonight, I had the sweet breath symptom, so I used ketostix (2 of them to reassure) and it they both read at the moderate level.

This should not be an issue of not eating enough carbs... I eat plenty!

Has anyone ever had this happen?

It can happen for many reasons. As long as you drink plenty of fluids to help flush them out, try not to worry about it :o)

Possible causes: 

1. exercise

2. more protein, less carbs (you already said this wasn't it)

3. illness

4. "leftover" ketones from previous highs 

5. other reasons i'm probably forgetting.... :o)

Thanks, C! You're awesome :-)

I think it means you do need insulin too though. I think you need to eat some carbs and take insulin for them. 

You might also want to get a blood ketone meter. The ketones in your urine are about 2 hours behind what your blood ketone level is. (Not sure on the fruity breath indicator.) The ketone meter works just like a BG meter, but it might not be covered by your insurance, but it wasn't that expensive. And you don't go thru the test strips as fast either.

You may need to take more insulin to help get rid of the ketones. And plenty of water!

Just a warning: if your blood sugar isn't high, you can't take insulin for ketones. You will still plummet and have a low. Only take insulin if you need it, not just because you have ketones. The point of insulin is to lower the blood sugar, so if your blood sugar is within a good range for you there's no need to take insulin.

Are you also losing weight at these times? Maybe you just need a bit more food intake so that your body doesn't need to burn fats to maintain body temp, etc.? Isn't burning fat what leads to ketones?

I'm sure this is very unlikely or you'd know, but I have to ask ... You aren't pregnant are you? That's the only time I've had ketones w/ a normal BG.

Hope you get this figured out!

my 13 year old is type 1 and he was sick to his stomach but his bs was only 179 but i still made him check for ketones he had ketones 15 min later his bs spiked to 233 and then 15 min later it went to 298 and had more ketones he threw up and said he felt better we got his sugar down and no more ketones it happened the next day at school he was only 159 with ketones our dr told us he might have a virus and for us to give him sugar to raise his sugar and then 15 mins later check his bs and give a correction  and it will help get remove the ketones . has this ever happened to any one before it was scary because we dont check for ketones unless its 300 or over i only checked because his stomach was hurting . this is so hard to watch your kid go through


Keytones aren't really dangerous, it's just a sign that something may be wrong.  They are produced when the cells don't have glucose and start burning fat for energy.

Keytones don't make your stomach hurt... that's probably from the illness.  Being sick is frustrating because blood sugars get unexplainably high.  You did everything right by correcting blood sugar and keeping your son hydrated.

Take care and glad your son is feeling better.  -Jenna

Hi Jenna.

I thought ketones are dangerous. Is that different the DKA? Are they related at all? My daughter thankfully has never had them.

Consider keytones as just a warning sign, to take care of whatever is causing the problem.  

DKA is caused when the keytones build up to a high level over time.  Our blood has buffers that maintain the pH level, but ketoacidosis uses up all the blood buffers and upsets the pH balance.

I've had diabetes over 30 years and have had DKA 3 times, all when I was a kid.  First instance was diagnosis when my blood sugar was 1,200.  The other times were when I had extended stomach bugs that caused high blood sugar (300+) and was severe dehydration, and high keytones for several consecutive days.  

In each case was obvious there was something wrong and needed emergency medical care.  I was delirious, panting (that's the body trying to get rid of the poisons), and barely able to stand.  The good news is that after a hydration and insulin IV, I was better within a couple hours.  

DKA used to be a more common cause of death for diabetics, but it's EXTREMELY rare now.  Because of glucose meters and IVs it's easy to see that there's a problem and fix it.  

I get sick when I have ketones, if they are high enough. Nausea/vomiting ect. are symptoms of DKA that I just looked up on Mayo Clinics website, or what I normally just call ketones. . . maybe that's what Michelle's son was experiencing? I've never been hospitalized tho, we just took care of it at home. by giving insulin by injection and waiting it out. I've also found that even if your blood sugar isn't all that high if you don't have insulin left in your system because your pump kinked off ketoacidosis happen a lot faster. I was off insulin because my pump kinked for about 3-4 hours and since my insulin only lasts 2 hours I had large ketones and was throwing up with a blood sugar of only 250 or so. On the other hand, I was at 400 last night for no apparent reason and was feeling fine besides being really thirsty.

We (me and my parents) were also told to eat some carbs without insulin, and then correct for the high. . . but what we misunderstood was that it should only be a couple of ounces of regular soda, not the whole soda. . . .oops!  It isn't safe to burn excess ketones all the time. It is normal to burn some between meals(for all people D and nonD), but you shouldn't be getting a readout on a urine stick on a regular basis, it's hard on your kidneys. The Atkins diet is based on burning ketones, and we asked my endo about it (not because i wanted to go on it, just because we saw an ad and they showed ketostix which we thought was weird) He said he would never recommend it for anybody because of the kidney issues and such.