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Ketone meter guide: blood vs urine ketone testing at home

By the Life in Good Form editors. Updated 2026-10-15.

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What ketones are

MedlinePlus explains that your cells normally use blood glucose for energy. If they cannot get enough glucose, your body breaks down fat for energy instead, and this produces acids called ketones. If fat is broken down too fast, ketones can build up in your blood and urine and make your blood too acidic, a serious condition called ketoacidosis.

The most common type is diabetic ketoacidosis (DKA), a complication of diabetes. MedlinePlus says DKA is a medical emergency that often develops quickly and can lead to a coma and be life-threatening.

Who checks ketones at home

• People with diabetes. MedlinePlus says DKA can affect anyone with diabetes but is most common with type 1 diabetes, and a blood ketones test may be used when you are sick or pregnant.
• Type 1 diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says your health care team may ask you to check your urine at home for ketones, and that a large amount may mean you need to manage your diabetes more carefully.
• Other risks. MedlinePlus lists vomiting or diarrhea that lasts a long time, alcohol use disorder, eating disorders and starvation among conditions that raise the risk of ketoacidosis.
• Keto diets. MedlinePlus notes that some people use at-home kits on a ketogenic diet; see the keto section below.

Blood meter or urine strips

MedlinePlus says at-home blood testing meters that check both glucose and ketones are available if your provider recommends frequent testing, and that at-home urine testing may also be an option. Talk with your provider about which is right for you.

Using a blood ketone meter

• Use ketone strips. MedlinePlus says you collect a drop of blood on a ketone test strip inserted into the meter, which then shows your ketone level.
• Follow the instructions carefully, as MedlinePlus advises.
• Know your plan. Ask your provider how you should test, when you should test, and what to do if your levels are high.
• Keep records. NIDDK says to keep a record of your self-checks with the date and time and the results, and to take it to your visits.

For the glucose side of a dual meter, see our glucose meter kit guide.

Using urine ketone strips

MedlinePlus says ketone test kits are available at most pharmacies without a prescription, and that at-home urine tests are easy to do and can give accurate results as long as you carefully follow all the instructions. Ask your provider which kit would be best for you.

To keep the sample clean, MedlinePlus describes washing your hands with soap and water, catching urine midstream, and not letting the container touch your body. Ask your provider whether you need to fast before testing.

MedlinePlus lists early symptoms of ketoacidosis as urinating a lot, extreme hunger or thirst, dehydration and headache, and severe symptoms as nausea or vomiting, belly pain, confusion, trouble breathing, feeling very tired or sleepy, and fruity-smelling breath. Large amounts of ketones can be life-threatening, so do not wait on a home result if symptoms are severe.

Keto diets and ketosis

MedlinePlus says people on a low-carbohydrate ketogenic diet will have blood ketone levels that are higher but not high enough to be ketoacidosis, a state called ketosis. Ketosis does not make your blood too acidic because your body can use the ketones. MedlinePlus adds that it is still possible to develop ketoacidosis on a keto diet, so talk with your provider to see if the diet is safe for you.

For a common keto diet ingredient, see our MCT oil guide.

What to look for when you buy

Questions people ask

What does a ketone meter measure?

Ketones in a drop of blood on a ketone test strip; many also measure glucose.

Are urine ketone strips accurate?

MedlinePlus says at-home urine tests can give accurate results if you carefully follow all the instructions.

Who should check ketones?

Mainly people with diabetes, especially type 1, when their provider advises it, such as during illness.

Is ketosis the same as ketoacidosis?

No. MedlinePlus says diet-related ketosis does not make blood too acidic, but ketoacidosis can still develop.

What symptoms need urgent care?

MedlinePlus lists confusion, trouble breathing, vomiting, belly pain and fruity breath; seek immediate medical help.

Sources

• Ketones in Blood (medlineplus.gov), MedlinePlus, U.S. National Library of Medicine
• Ketones in Urine (medlineplus.gov), MedlinePlus, U.S. National Library of Medicine
• Managing Diabetes (niddk.nih.gov), National Institute of Diabetes and Digestive and Kidney Diseases

Sources checked 2026-10-15.