27. Blood Glucose and Urine Ketone Testing

Diabetes Planned Visit Notebook

Summa Health System developed this fact sheet for patients with diabetes to help them better understand blood glucose and urine ketone testing. Care providers give it to patients during diabetes planned visits, and it is part of the Diabetes Planned Visit Notebook.

Blood Glucose and Urine Ketone Testing

Family Medicine Center

All people with diabetes should try to keep the amount of glucose in their blood as near to normal as possible. This is called being in control. Keeping blood glucose levels near the normal range can help prevent or delay the start of such diabetes side effects as nerve, eye, kidney, and blood vessel damage

Recommended blood glucose levels are:

Before meals1-2 hours after mealsAt bedtime
Between 80-120 mg/dlLess than 180 mg/dlLess than 140 mg/dl

Testing at regular times each day is the only way to know for sure if you are in good control.

  • Test if you feel symptoms of low blood sugar (dizzy, shaky, anxious, sweaty, hungry).
  • Test if you feel symptoms of high blood sugar (hyperglycemia), tiredness, frequent thirst, frequent urination.
  • Test your sugar every 4 hours if you are sick.

If you manage diabetes with diet, exercise, and diabetes pills:

  • Test before breakfast.
  • Test before your main meal, and
  • 1½ hours after finishing your main meal.
  • Or, follow the staggered schedule below.

If you take insulin:

  • Test before each meal.
  • Test before your evening snack.
  • or, follow the staggered schedule below.
Day of the WeekBreakfastLunchSupperBed
 BeforeAfterBeforeAfterBeforeAfter 
MondayXX    X
TuesdayX XX   
Wednesday    XX 
ThursdayXX    X
FridayX XX   
Saturday    XX 
SundayXX    X

Recording Your Results

By writing down your results each time you test, you will have an accurate picture of your blood glucose levels. You may notice a relationship between certain behaviors and high or low glucose.

Blood glucose levels may be Higher if You:

  • Eat more food than usual.
  • Exercise less than usual.
  • Take too little insulin or forget pill(s).
  • Are ill or under stress.

Blood glucose levels may be Lower if You:

  • Eat less food than usual.
  • Exercise more than usual.
  • Take too much insulin or pills.
  • Skip a meal or snack.

Call your physician if:

  • Glucose levels are over 240.
  • Glucose levels are under 60.

Urine Testing

Purchase urine dip test sticks (Ketostix) to test for ketones. Urine testing for ketones is a very important tool especially when your diabetes is out of control or when you are sick. Ketones can be a sign of serious problems that can lead to a diabetic coma.

Ketone test strips (Ketostix) can be found at the same places you get other diabetes supplies. They are easy to use.

To use them:

  • Dip a ketone test strip into a sample of urine.
  • Wait the number of seconds the instructions say. The color of the pad on the strip will change if there are ketones in the urine.
  • Compare the color of the pad to the color chart on the bottle or box.
  • Record the test result on your testing log.

Test your urine for ketones when:

  • Your blood sugar is over 240 mg/dl.
  • You feel sick or have a cold, the flu, or an infection.
  • You are vomiting or feel sick to your stomach.
  • You have symptoms of high or low blood sugar.
  • You are pregnant.
  • Call your doctor immediately if your test shows moderate or large amounts of ketones in your urine.

If you have any questions regarding blood glucose testing and urine testing, please call the Family Medicine Center at (330) 375-3584.

Page last reviewed January 2008
Internet Citation: 27. Blood Glucose and Urine Ketone Testing: Diabetes Planned Visit Notebook. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/diabnotebk/diabnotebk27.html