16
Expected Blood Glucose/β-Ketone Control Goal
1. Blood Glucose Reference Ranges
Expected blood glucose values for people without diabetes:
1
Time of Day
Glucose Range
Fasting and before meals
<100 mg/dL
2 hours after meals
<140 mg/dL
Warning:
•
If your blood glucose result is below 50 mg/dL (or you see LO, less than 20 mg/dL) or is
above 250 mg/dL (or you see HI, greater than 600 mg/dL) on the meter, please contact
your healthcare professional as soon as possible.
•
Please contact your healthcare professional if you decide to make a change to your
current medical therapy based on test results.
2. Blood β-Ketone Reference Ranges
The blood β-ketone test measures Beta-Hydroxybutyrate (β-OHB), the most
important of the three ketone bodies in the blood.
2
The normal adult blood β-Ketone
range for a person without diabetes is less than 0.6 mmol/L.
3
β-OHB levels may
increase if a person fasts, exercises vigorously or has diabetes and becomes ill.
2,4
If your blood β-ketone result is 0.0 mmol/L and your blood glucose result is 300
mg/dL or higher, repeat both the ketone and the glucose tests with new test strips. If
the same message appears again or the result does not reflect how you feel,
contact your healthcare professional. Follow your healthcare professional’s advice
before you make any changes to your diabetes medication program.
If your blood β-ketone result is between 0.6 and 1.5 mmol/L and your blood glucose
result is 300 mg/dL or higher, this may indicate the development of a problem that
could require medical assistance. Follow your healthcare professional’s instructions.
If your blood β-ketone result is higher than 1.5 mmol/L and your blood glucose result is
300 mg/dL or higher, contact your healthcare professional promptly for advice and
assistance. You may be at risk of developing diabetic ketoacidosis (DKA).
3-7
References:
1. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2018;
vol.41 (supplement 1): S13-S27.
2. Schade DS, Eaton RP. Metabolic and clinical significance of ketosis. Special Topics in
Endocrinology and Metabolism 1982; 4: 1-27.
3. A. Rewers, Current Controversies in Treatment and Prevention of Diabetic Ketoacidosis,
Advances in Pediatrics 57 (2010): 247-267
4. Harano Y, Kosugi K, Hyosu T, Suzuki M, Hidaka H, Kashiwagi A, Uno S, Shigeta Y. Ketone
bodies as markers for Type 1 (insulin-dependent) diabetes and their value in the monitoring of
diabetes control. Diabetologia 1984; 26: 343-348.
5. Ubukata E. Diurnal variation of blood beta-Ketone bodies in insulin-dependent diabetes
mellitus and noninsulin-dependent diabetes mellitus patients: The relationship to serum
C-Peptide immuno reactivity and free insulin. Ann Nutr Metab 1990; 34: 333-342.
6. Luzi L, Barrett EJ, Groop LC, Ferrannini E, DeFronzo RA. Metabolic effects of low-dose insulin
therapy on glucose metabolism in diabetic ketoacidosis. Diabetes 1988; 37: 1470-1477.
7. Hale PJ, Crase J, Nattrass M. Metabolic effects of bicarbonate in the treatment of diabetes
ketoacidosis. Br Med J 1984; 289: 1035-1038.
