Confusion about Ketone blood results. (2025)

Hi,

I'm on Metformin and Dapagliflozin 10mg and only got alerted by the NHS message app about the rare but serious side effect of Ketoacidosis for Dapa.

I got bought myself the keto finger prick testing kit but unsure of what the result means as the main market for these kits seems to be the Keto diet and weight loss market to see if they're achieving Ketosis (which seems different to the one you don't want to get?). But I don't understand why a higher number is what those on Keto diet actually want to achieve.....but I presume I want it on the lower end to not go towards DKA.

How can the those on the diet not be in danger with high readings but diabetics want lower readings to stave of the dangers of DKA?

I'm confused with what's what.

All I can share is I did the finger prick ketone test, and it showed 0.1mmol ....is that good or what? I'd be grateful to anyone who shines a light on the numbers confusion and whether my reading is a good one.

Thanks very much 🙂

@madfish There have been cases of people eating a keto diet getting ketoacidosis. Your concern is ketoacidosis due to your medication. Here are the numbers from the NHS showing what your results mean. Your 0.1 is fine. Look below:

If you use a meter to test for ketones in your blood:

• under 0.6mmol/L is normal
• 0.6 to 1.5mmol/L is slightly high – test again in 2 hours
• 1.6 to 3mmol/L means you're at risk of DKA and should speak to your diabetes care team for advice
• over 3mmol/L is high and means you may have DKA and should call 999 or go to A&E

If you use strips to test for ketones in your pee, over 2+ is high. This means you may have DKA and should call 999 or go to A&E.

EDITED POST - this chart shows what the Ketone readings mean

mashedupmatt said:

As a rule you only need to check for Ketones if BG is high - this chart shows what the readings mean

View attachment 33768

Click to expand...

But the OP is on a flozin, where DKA is a risk with normal BGs.

silentsquirrel said:

But the OP is on a flozin, where DKA is a risk with normal BGs.

Click to expand...

I stand corrected - apologies - 0.1 is nothing to worry about though, which is good!

mashedupmatt said:

As a rule you only need to check for Ketones if BG is high - this chart shows what the readings mean

View attachment 33768

Click to expand...

No you don’t. Not when you’re on dapagliflozin, and the OP clearly stated in their post that their GP has warned them about the risk of DKA on this medication.

madfish said:

Hi,

I'm on Metformin and Dapagliflozin 10mg and only got alerted by the NHS message app about the rare but serious side effect of Ketoacidosis for Dapa.

I got bought myself the keto finger prick testing kit but unsure of what the result means as the main market for these kits seems to be the Keto diet and weight loss market to see if they're achieving Ketosis (which seems different to the one you don't want to get?). But I don't understand why a higher number is what those on Keto diet actually want to achieve.....but I presume I want it on the lower end to not go towards DKA.

How can the those on the diet not be in danger with high readings but diabetics want lower readings to stave of the dangers of DKA?

I'm confused with what's what.

All I can share is I did the finger prick ketone test, and it showed 0.1mmol ....is that good or what? I'd be grateful to anyone who shines a light on the numbers confusion and whether my reading is a good one.

Thanks very much 🙂

Click to expand...

Blood ketone strips are more expensive than the urine test strips and may have quite a short shelf life. Which monitor do you have as not all will read ketone blood strips.

Leadinglights said:

Blood ketone strips are more expensive than the urine test strips and may have quite a short shelf life. Which monitor do you have as not all will read ketone blood strips.

Click to expand...

Hi, I bought and used this one ketone test kit

I had some ketone blood strips which I was able to use with my Libre reader, but as others have said they have a short life and they went out of date before I used them. I now have a test kit that uses both blood glucose and blood ketone test kit. I also have urine test strips.

In my sick day rules any reading of 1.5 (+ or ++) or more needs urgent treatment, and if 3 (+++ or ++++) or more with vomiting to get to A &E for emergency treatment.

SB2015 said:

I had some ketone blood strips which I was able to use with my Libre reader, but as others have said they have a short life and they went out of date before I used them. I now have a test kit that uses both blood glucose and blood ketone test kit. I also have urine test strips.

In my sick day rules any reading of 1.5 (+ or ++) or more needs urgent treatment, and if 3 (+++ or ++++) or more with vomiting to get to A &E for emergency treatment.

Click to expand...

I bought some for mine too they were expensive as well as expired.