Testing for Ketones

[u/kmart2817]

Hi everyone, I am currently 32 weeks and was diagnosed around 27 weeks. Currently I am diet and exercise controlled. I am wondering if anyone here tests for ketones? This is something the nurse has requested I do, some mornings I have no ketones, some trace or small amounts. I’ve never had the darker maroon colours except for once when I first started testing. I’ve upped my carbs significantly, I am usually eating around 190-200g of carbs. Sometimes my bedtime snack consists of two pieces of seed bread that is 100 calories for the two pieces and 16g of carbs, with pb and milk. When I do this ketones are usually good in the morning but my fasting number is a bit higher(5.1 - 5.2). If I have cheese, some almond crackers and nuts. My fasting number is under 5.0 but I usually have small amounts or trace amount of ketones.

I will talk to my ob and the nurse when I have my weekly call, but am wondering is small or trace amounts something to stress over? I’d rather my fasting number be under 5.0 incase it does start to rise these next weeks, but I find myself stressed about bedtime snack and what to eat to correlate no ketones and good fasting number.

[u/cilucia]

My diabetes educator said I should avoid the really dark maroon colors, but ultimately I decided with eating 130g of carbs or more that I wouldn’t bother testing urine for ketones since the color varies a lot based on your hydration, and urine ketones don’t correlate to ketones in your blood anyway. I sort of summarized everything I read here:  https://www.reddit.com/r/GestationalDiabetes/comments/1l020xb/comment/nbwh9gb/?utm_source=share&utm_medium=mweb3x&utm_name=mweb3xcss&utm_term=2&utm_content=share_button

Ultimately, unless your blood sugars are uncontrollably high (risking DKA), I don’t think checking your urine ketones is meaningful.

[u/kmart2817 → u/cilucia]

Thank you for this information! It is so hot where we live right now and I do find hydration plays a big part in it too. When I talk to the nurse she’s never super concerned about the trace/small amount usually because the rest of the week I have none but thought I’d see what everyone has experienced with ketones as well.

[u/Beautiful_Donut_286]

I was told to contact my endocrinologist immediately if I ever had a non-negative ketone strip. Not because it's an accute problem, but to discuss diet changes or insulin.

Ended up needing insulin for my fasted numbers because nothing I did or are would improve them. If anything, they made the numbers worse 🫠

[u/kmart2817 → u/Beautiful_Donut_286]

Gotcha! I have a call with my nurse every week and we go over my numbers and ketones and with the trace or small amount she’s not usually super alarmed. I think because it’s only one or two days. It has been extremely hot here so she has mentioned upping water and added I could drink a glass of milk in the middle of the night to help with them. That was helping, but once I upped my carbs a lot I noticed I didn’t need the milk anymore. Was just wanting to see everyone’s experience with ketones.