The page below is a sample from the LabCE course Diabetes: Diagnosis, Laboratory Testing, and the Current American Diabetes Association Guidelines. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Testing for Ketones

Ketones are produced when glucose is not available to supply the body's cells with energy.  This can occur when  insulin levels are insufficient or lacking. To make energy, the body then begins breaking down fat into acetyl CoA.
The acetyl CoA  produced is converted to acetone, acetoacetate, and beta-hydroxybutyrate. These are acids and when dissolved in body fluids in excess, they lower the blood pH. Increased ketones can result in a metabolic acidosis referred to as ketosis, ketoacidosis, or diabetic acidosis. Type 1 diabetic patients are especially at risk for ketoacidosis.
Urine and serum ketones are measured semi-quantitatively and a diabetic in ketosis is monitored for ketones and blood pH.