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What is Ketonuria?

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Ketonuria is a medical condition that occurs after having high ketone levels in your urine. It is typically diagnosed in individuals with diabetes, particularly type 1 diabetes.

In this article, we will explain the development of ketonuria, its symptoms, causes, and treatment options. We also listed preventive measures that you can follow to inhibit the said condition from happening.

Ketones and Ketonuria

Ketones are types of acids that develop following the breakdown of fats or proteins for energy conversion. These acidic molecules are made in the liver. When the body does not have enough sugar for energy, it uses ketones instead. The body then tries to get rid of excess ketones through urine, which results in ketonuria.

Without proper treatment, high levels of ketones can trigger an acidic buildup in the blood. This process leads to ketoacidosis, a diabetes complication that can be both harmful and severe.

What are the symptoms of ketonuria?

When you have ketonuria, you may already have ketoacidosis. The following symptoms of ketonuria are as follows:

  • Frequent thirst
  • Fruity smelling breath
  • Dryness of the mouth
  • Fatigue or tiredness
  • Nausea or vomiting
  • Frequent urination
  • Concentration problems
  • Headache or dizziness

Other bodily reactions that may link you with it:

  • High blood sugar (hyperglycemia)
  • Episodes of dehydration
  • Imbalance of electrolytes
  • Signs of urinary tract infections

What are the causes of ketonuria?

Diabetes – One of the common causes of ketonuria is diabetes. It is a condition that happens when the body has low insulin levels, resulting in a spike in blood sugar. When there isn’t enough insulin supply, the body isn’t capable of moving sugar into the cells for energy storage. This process enables the body to find another source. This source will involve the conversion of fats and protein being broken down for energy use. As a result, ketones are produced. 

When there are too many ketones produced, the body tries to get rid of them through urine. This is how ketonuria develops, which also indicates that diabetic ketoacidosis already exists.

Keto Diet – A ketogenic diet is a type of diet that involves eating fats and protein instead of regular food consumption, where carbohydrates are more commonly a part of the menu. While this is a good diet, it primarily relies on fats and protein for fuel, which is one of the most common ways how ketonuria develops.

Other causes of ketonuria are as follows:

  • Excessive alcohol consumption
  • Frequent vomiting
  • Illness or infection
  • Episodes of heart attacks
  • Emotional disturbance
  • Physical trauma
  • Using corticosteroids
  • Excessive drug use

How to treat it?

Treatment of ketonuria depends on what causes it. If the condition is due to a change in diet, treatment is not necessary as it resolves by simply changing what you eat. However, if ketonuria occurs because of more complex situations, the following may be needed:

  • Insulin injections
  • Intravenous (IV) drips
  • Supply of electrolytes (chloride, potassium, or sodium)

If it is happens because of illnesses or infections, additional treatment with antiviral or antibiotics is necessary.

How to prevent it?

If you have diabetes, the best way to prevent complications like ketonuria is by controlling blood sugar levels well. Besides following daily insulin shots or oral medications, monitoring your blood sugar levels will help you determine your status. You also need to be aware of the symptoms of ketonuria so that when they appear, you can obtain immediate medical care.

Doctor’s Recommendation

Ketonuria is not necessarily a problem. In fact, it may be a beneficial finding. The only relevant thing is the concentration of the ketones in the blood so that they do not exceed approximately 8 to 10 mmol/L as then, in fact, the blood pH can drop. Nutritional ketosis is actually a desired state. Individuals who are insulin dependent may need to monitor their ketones, whereas type 2 diabetics who are not insulin dependent do not have to be overly concerned with excessive ketones being produced because insulin is also released under periods of intense starvation to prevent runaway ketosis. Runaway ketosis is possible in type 1 diabetics and type 2 diabetics with severe dependence on insulin. Furthermore it is worth noting that as an individual becomes more acclimatized to beginning ketosis a smaller percentage of the ketone bodies will end up in the urine, therefore only the ketones measured from blood should be taken seriously.

Medically Reviewed

Profile image of Dr Pawel Zawadzki

Medically Reviewed By Dr Pawel ZawadzkiDr. Pawel Zawadzki, a U.S.-licensed MD from McMaster University and Poznan Medical School, specializes in family medicine, advocates for healthy living, and enjoys outdoor activities, reflecting his holistic approach to health.

Profile image of CDI Staff Writer

Written by CDI Staff WriterOur internal team are experts in many subjects. on November 11, 2022

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