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When the body relies on fats, rather than carbohydrates, as its main energy source, increased levels of ketones occur in the blood and urine. The presence of detectable levels of ketones in the urine is called ketonuria. Ketones occur in three forms in the body: beta-hydroxybutyrate (BHB), acetone and acetoacetate.
Any diabetic patient who has elevated levels of blood and urine glucose should be tested for urinary ketones. In addition, when diabetic treatment is being switched from insulin to oral hypoglycemic agents, the patient's urine should be monitored for ketonuria. The development of ketonuria within 24 hours after insulin withdrawal usually ...
Their excretion in urine is very low and undetectable by routine urine tests (Rothera's test). [18] When the rate of synthesis of ketone bodies exceeds the rate of utilization, their concentration in blood increases; this is known as ketonemia. This is followed by ketonuria – excretion of ketone bodies in urine. The overall picture of ...
Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability. . In physiological ketosis, ketones in the blood are elevated above baseline levels, but the body's acid–base homeostasis is maintain
The term ketones or ketone bodies in reality refers to three intermediate products in the metabolism of fatty acids; acetone, acetoacetic acid and beta-hydroxybutyric acid. Elevated concentrations of ketones are not generally found in urine, as all these substances are completely metabolized, producing energy, carbon dioxide and water.
Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. [6] In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis"). [3] A pH measurement is performed to detect acidosis.
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Ketogenesis pathway. The three ketone bodies (acetoacetate, acetone, and beta-hydroxy-butyrate) are marked within orange boxes. Ketogenesis is the biochemical process through which organisms produce ketone bodies by breaking down fatty acids and ketogenic amino acids.