Table 1

Cut points for ketosis/DKA and corresponding remedial actions

Blood ketone (BHB) levelUrine ketone*Remedial actions
<0.6 mmol/L (normal)NegativeNo action needed
0.6–1.5 mmol/L (ketonemia)Trace or smallTreat as follows or per clinician instructions:
 • Ingest 15–30 g rapidly absorbed carbohydrate and maintain fluid consumption (300–500 mL) hourly
 • Administer rapid-acting insulin based on carbohydrate intake (hourly)
 • Check blood/urine ketones (every 3–4 h) until resolution
 • Check blood glucose frequently to avoid hyperglycemia and hypoglycemia
Seek medical attention if levels persist and symptoms present
1.6–3.0 mmol/L (impending DKA)ModerateFollow treatment recommendations listed above
Consider seeking immediate medical attention
>3.0 mmol/L (probable DKA)Large to very largeSeek immediate medical attention
  • BHB, β-hydroxybutyrate.

  • * Urine ketone concentrations are dependent on hydration and other factors; these values do not closely correlate with blood BHB levels.