Monitoring the levels of ketone bodies in the urine is

• A. Considered essential on a daily basis for all diabetic patients
• B. A reliable method of assessing long-term glycemic control
• C. Recommended for patients with type 1 diabetes on sick days
• D. Not recommended by the ADA

Answer: (C)

Monitoring urine ketones is especially helpful for people with type 1 diabetes during illness. When illness occurs, insulin levels can be insufficient relative to stress hormones, prompting the body to burn fats and produce ketone bodies. If these ketones accumulate, they can lead to diabetic ketoacidosis. Checking urine ketones on sick days provides an early warning sign, guiding actions such as staying hydrated and adjusting insulin under medical guidance to prevent DKA.

This isn’t something required daily for all diabetics, and urine ketone testing doesn’t reflect long-term glycemic control—that's better assessed by HbA1c and average glucose. Also, the urine test mainly detects certain ketone forms and can miss others, and urine levels can lag behind blood levels or be affected by urine concentration. In some cases, blood ketone testing is preferred for a more accurate, real-time picture, especially during illness. But during sick days for type 1 diabetes, monitoring urine ketones remains a recommended precaution.