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When the body does not have sufficient insulin to use glucose for energy, it will try to use fat instead. After a while, by-products of fat metabolism appear in the bloodstream. These are called ketones.
Ketones are usually noticed when they start to spill over into your urine, or are expelled through your lungs, as the body attempts to filter them out of your blood. When ketone levels are high, you will notice a fruity smell to the breath, that is reminiscent of alcohol. The urine odor also changes.
Ketones are a toxic by-product of fat metabolism, and signal a serious problem in the management of your disease. High blood levels of ketones can cause coma and death, if left untreated.
Urine dipsticks are available that can test for the presence of excess sugar and ketones in your urine. Well-controlled diabetics rarely spill ketones into the urine, as ketone production is an indicator of high blood sugar levels and unstable diabetes.
Talk to your doctor about how frequently he or she wants to you check your ketone status. When in doubt, check it out!