accumulation of ketone bodies in the urine. When ketone is excreted, sodium is excreted along with it.

Symptoms and Treatment

Symptoms of glucose and ketone-body overload include thirst, frequent urination, dehydration, nausea, vomiting, heavy breathing, dilation of the pupils and confusion resulting from the toxic effects of ketone bodies and acid accumulation on the brain. In addition, the symptoms may also include a breath odor resembling the smell of fruit. (One type of ketone, acetone, is excreted through the lungs, causing the fruity smell.) This symptom-complex can progress to coma and death.

Treatment with insulin and intravenous fluids can restore normal levels of blood sugar and end ketoacidosis and ketonuria.


Prevention of emergencies in diabetics prone to ketonuria requires close monitoring of the levels of glucose in the blood and ketone bodies in the urine. Although ketone-body overload in the blood occurs primarily in type 1 diabetics, it can also occur in people with type 2 diabetes. Therefore, it is commonly recommended that all diabetics should closely monitor not only their glucose levels but also their ketone levels. Home tests kits are available to check both glucose and ketone levels.

Ketogenic Diet

Ironically, ketonuria is a desired effect of a special “ketogenic diet” used to prevent or reduce the number of seizures in people with epilepsy (seizure disorders). Some physicians use this diet when conventional medications fail to control seizures or when the side effects of medications become intolerable.

The ketogenic diet, which is high in fats and low in protein and carbohydrates, mimics starvation and raises the level of ketone bodies in the blood. The ketone bodies can prevent or decrease the incidence of many types of seizures, including myoclonic (spastic) and atonic (drop) seizures. They may also limit other types of seizures, including so-called staring spells. Why ketone bodies may inhibit such seizures is not known.

The ketogenic diet is very strict and must be closely managed under a physician’s supervision. Only a limited number of medical centers are equipped and trained to prescribe it.

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