When you eat, your body breaks down foods into usable sources of energy. Glucose is the sugar that results. Your body needs glucose for energy and your baby needs it to grow. In order to get glucose out of your blood and into your cells, insulin is required. Insulin is a hormone that you produce in your pancreas. “In gestational diabetes, hormones produced during pregnancy can interfere with insulin and make it hard to use glucose. If the pancreas cannot produce enough insulin to overcome the effects of the hormones, the blood sugar will rise,” explains Louise McDonald, RN, clinical manager of maternity and pediatrics at Cleveland Clinic Home Care. “The body cannot use sugar without enough insulin. That causes the body to break down fats as a source of energy. Ketones are the waste products that are left over when the body burns some of its own fat for fuel. The ketones pass from the bloodstream into the urine,” says McDonald. Why Are Ketones Important in Gestational Diabetes? The treatment of gestational diabetes is aimed at keeping your blood sugar under control. This is done with a combination of diet, exercise, and sometimes insulin treatment. Finding ketones in your urine is a warning sign that your blood sugar control is out of balance.
High blood sugar. If you are taking in more sugar in your diet than your insulin can manage, your blood sugar goes up. This is dangerous for you and your baby. If your baby is exposed to more sugar then the baby needs, the baby will grow too fast. This condition, called macrosomia, can lead to problems during delivery.Low blood sugar. Your body may also turn to fat as a source of energy if your blood sugar is too low. This can happen if you skip a meal or during the night when you go for a long period without eating. In some women who are overweight, a low-calorie diet may not be supplying enough sugar. Ketones in your urine may be a sign that you and your baby are not getting enough energy fuel in your diet.Ketones and your baby. Some studies have shown that excess ketones in a pregnant woman’s urine may affect developing brain cells and lead to babies with a lower IQ and future learning disabilities. Although other studies were not able to confirm these findings, many doctors feel safer testing for ketones and avoiding them by adjusting your diet or medication.
Gestational Diabetes: How and When to Test Your Urine for Ketones The recommended time for women with gestational diabetes to test for ketones is in the morning to see if the baby is receiving enough nutrition through the night. Testing is quick and simple: A ketone dip-and-read test strip, available at a pharmacy, is dipped into a morning urine sample. If the strip changes color, ketones are present in the urine. “Ketone test strips are sensitive to light and moisture, so it is a good idea to keep them stored in the container with the lid on tight. Check the expiration date on the bottle and do not use strips that are expired,” says McDonald. If you have gestational diabetes, you need to keep your blood sugar under control. Testing for ketones in your urine is one of the ways that you and your gestational diabetes management team can know how you are doing. Occasional ketones in your urine are not unusual and may not signal a big problem, but always let your management team know and work with them to get your blood sugar under control. Keeping ketones out of your urine is one way to make sure you are doing what’s best for you and your baby.
