Diabetesblogs

Ketone Levels Chart: Blood mmol/L and Urine Strips

By the Diabetes Blogs editorial teamLast reviewed

Sources: ADA; Breakthrough T1D; CDC; MedlinePlus (full list)

Blood ketones under 0.6 mmol/L are normal in charts for people with diabetes; 0.6 to 1.5 is elevated; 1.5 to 3.0 means risk of DKA; above 3.0 is an emergency. The ADA’s own line is that a blood ketone level of 1.6 mmol/L or higher means seek emergency care immediately.

Blood ketone meter (mmol/L)

Blood ketonesMeaningWhat to do
Below 0.6 mmol/LNormalNo action needed.
0.6 to 1.5 mmol/LElevatedWatch closely. If ill, call your care team and follow your plan.
1.5 to 3.0 mmol/LRisk of DKA. The ADA says 1.6 or higher needs emergency careCall your care team right away; go to emergency care if 1.6 or higher or unwell.
Above 3.0 mmol/LMedical emergencyCall your care team immediately and go to the ER.

Bands: Breakthrough T1D. Emergency line at 1.6 mmol/L: ADA, “DKA: Signs, Symptoms, and Treatment”. The ADA page we reviewed gives only the 1.6 line, so the lower bands are the charity’s.

Urine ketone strips

Strip resultMeaningWhat to do
Negative or traceNormalNo action needed.
SmallKetones presentWatch closely. If ill, call your care team.
ModerateRisk of DKACall your care team right away.
LargeMedical emergencyCall your care team now and possibly go to the ER.

Categories: Breakthrough T1D. Strip brands print different strength ranges, so use the chart on your bottle.

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How to use the chart

  • Blood meters are preferred over urine strips by the ADA. Either can start a conversation with your care team.
  • Test when it matters: when you are sick or your blood sugar is 250 mg/dL or higher (CDC), and as your care team advises.
  • Symptoms outrank numbers. See DKA symptoms.
  • These tables are information, not a treatment plan. Your clinician may set different action levels for you.

New to testing? Read ketones in urine. If your glucose is high, see 250 and 300.

Frequently asked questions

What is a normal blood ketone level?

Under 0.6 mmol/L is the usual “normal” in patient-education charts for people with diabetes. The ADA gives one emergency line: at 1.6 mmol/L or higher, seek emergency care immediately.

Why do charts disagree about 1.5 and 1.6?

Different organizations draw the lines in slightly different places. Charity charts use 1.5 as the start of the DKA-risk band; the ADA says 1.6 mmol/L or higher needs emergency care. If you are between them and unwell, treat it as urgent.

What do urine strip colors mean in mmol/L?

Strips usually report categories (negative, trace, small, moderate, large) and sometimes a mg/dL range that differs by brand, so there is no single conversion to the mmol/L of a blood meter. Use your strip’s own chart.

What level of ketones is dangerous?

Per the charts: above 3.0 mmol/L is an emergency, and 1.5 to 3.0 mmol/L carries a risk of DKA. Per the ADA, 1.6 mmol/L or higher needs emergency care. With symptoms of DKA, do not wait for a number.

Does a keto diet cause these readings?

MedlinePlus lists a low-carbohydrate keto diet among the reasons for ketones in people without diabetes. In a person with diabetes, ketones with high glucose or illness are a warning sign, so ask your care team before trying a very low-carbohydrate diet.

Information only, not medical advice. Your care team may set different targets for you, and only a lab test ordered by a clinician can diagnose diabetes or prediabetes. See our medical disclaimer.

Sources

Last reviewed: by the Diabetes Blogs editorial team. Information only, not medical advice.

Related tools and guides

Ketones in urine

What ketones are, when to test, and when to get urgent help.

DKA symptoms

Warning signs of diabetic ketoacidosis and why it is an emergency.

Blood sugar of 250

The CDC advice on checking ketones, and the warning signs that need urgent care.

Blood sugar of 300

When 300 mg/dL means emergency care, from CDC guidance.