GD and ++ ketones in urine

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I have GD (diet controlled) and earlier today went for a growth scan and follow up appointment. All looked good but I've just checked the notes on the hospital's app and seen that my urine sample tested ++ for ketones. Should I be concerned or would they have said something if it was a problem? I'm not sure what the threshold is. I'd had a fairly carby lunch not long before, I occasionally have a low fasting reading but don't generally have low sugars when I test after eating.

Hi, speaking from experience as a type 1 diabetic and not GD. Ketones can be present even in someone who doesn’t have diabetes after fasting sometimes or high fat food or high protein food. Think of the concept of the keto diet. The test for ketones will be to avoid sustained ketones in your blood and then going into diabetic ketoacidosis (very dangerous). If your blood sugar readings are good and this is a one off and they didn’t bring it up then I am sure it’s fine. If you are worried call the diabetic midwife to discuss, in my experience they are pretty responsive.

Thanks! My post meal readings are generally good and were after lunch today (an hour or so before the sample). I thought I was doing well! Now I'm wondering if I've overdone cutting down on carbs. I'm reading about the risks of ketones in pregnancy and scaring myself - seems like I can't get it right, either high glucose levels or ketones! I've messaged my diabetic midwife so hopefully will hear back soon.

I had exactly this 8 weeks ago (at 36w pregnant). Midwife wasn’t concerned at all and said I was probably dehydrated and needed to eat/ drink more regularly. Good luck!

PS I would recommend the GD Uk facebook group if you’re not a member. You can get loads of advice from experts there :)

It’s a nightmare to try to get it right but it seems like what you are describing is the amount of ketones anyone might have in their blood at any time. Think of those women who have a lot of morning sickness and aren’t eating much. They will definitely have ketones but it’s not a problem. The worry with ketones is if they are sustained.

Look forward to the end of y our pregnancy when you will have a lovely baby and can gorge guilt free on carbs again 😀👍

Ok good to know that ++ isn't that high! It's such a minefield. Definitely have a new understanding of what 'proper' diabetics go through and very much looking forward to that post-birth toast!