Definition: Ketones are acids the body makes when it burns fat for energy because its cells cannot get enough glucose. MedlinePlus says they can build up in the blood and urine, and that very high levels can make the blood too acidic, as in diabetic ketoacidosis (DKA).
MedlinePlus lists other reasons ketones can rise:
MedlinePlus calls DKA a medical emergency that often develops quickly and can be life-threatening. A urine test can be done at home with test strips or in a lab. The NCI notes ketones are made by the body when there is not enough insulin.
The Farxiga label lists ketones in the urine or blood, even when blood sugar is under 250 mg/dL, among signs of possible ketoacidosis that need a call to a provider or emergency help right away. The Invokamet label says ketone checks may be considered in people at risk. Invokamet also describes metformin lactic acidosis as an acidosis without ketones, a different problem.
Because ketoacidosis on an SGLT2 drug can come with normal blood sugar, a glucose reading alone may not tell the whole story. Logging ketone results with the time, your meals and how you felt gives your provider the full picture.
Read more on Dose Track: SGLT2 medicines and keto diets · Farxiga side effects · Invokamet side effects · SGLT2 medicines before surgery