Then I'm walking down the hall and I go, "Wait... If I'm over 200, I'm going to give myself more insulin anyway. So what's the point of that Ketone test?"
they try not to confuse the heck out of us, and then make things more complicated by oversimplification.
keytones are fine and they are normal and everyone of us diabetic or not will have keytones in our urine if we are losing weight or exercising (using the fat in our bodies). there's no reason to call a hospital if you just have keytones.
SO what's the point of the test? okay, in the event your blood sugar is very high, typically as a result of way too little insulin, your body will begin to burn fat and muscle for basic energy, because the sugar can't be used for energy without insulin, even if it reaches 300+ in your bloodstream. This can be corrected with insulin, however, if your sugar is high, and it's been some time, and your body is burning fat for energy - then keytones, the by-product of fat metabolism, can reach a very high level, sometimes quickly, and this becomes a runaway reaction. So "runaway" in fact that insulin isn't going to save you. When this happens you need to get yourself ot a hospital for IV fluids, and continue insulin, and observation or (and now I'll simplify) you'll be horribly sick and can die.
so if you have high blood sugar, correct the way you normally correct. if you have high bs and keytones... this means "danger": so you correct and keep checking (bs comes down, keytones go away or are very small) till your good. if you have high bs, high keytones, your bs isn't coming down with insulin and you have ketoacidosis symptoms... get to a ER.
sorry it's long... I am not sure if I made it better or worse... =)