To provide a person and all his organs with energy, the body breaks down glycogen and produces glucose. For the work of the brain, it is the main energy supplier. Unfortunately, glycogen stores are very limited. When they run out, the body switches to other sources of energy - ketones. In the urine and blood of a he althy person, they are practically absent. The detection of these substances in the analysis indicates an existing pathology.
What are ketones
The name "ketone" comes from the German "acetone". Ketones are substances whose molecules have an organic compound of oxygen with hydrogen and two hydrocarbon radicals. There are many varieties of ketones. For example, ubiquinone, it is extremely important for the work of the heart. They contain the ketone group, the well-known fructose, menthone, which is part of oral care preparations, carvone, used in the food industry, progesterone, cortisone, even tetracycline. Each of us has ketones in the urine and blood, excreting approximately 20-50 mg daily, of which 70% is weak beta-hydroxybutyric acid, 36% is strongeracetoacetic acid and 4% for acetone. The last element is least of all, because it can be released from the body during breathing. Lange, Legal and others do not show such a meager amount of the sample. That is why it is believed that in a he althy person, the norm of ketones in the urine is their complete absence.
Ketonuria and ketoacidosis
In medicine, there are several conditions associated with ketones. When there are a lot of them in the blood, they talk about ketonemia, and in the urine - about ketonuria. With a sufficiently high content of ketone bodies, PH begins to be disturbed and ketoacidosis develops. If there are a lot of ketones, but in the blood until electrolyte changes have begun, they speak of ketosis. Ketonuria is observed in people with impaired protein, fat or carbohydrate metabolism. This condition often occurs in young children and pregnant women.
There are a number of factors that cause ketones to be detected in the urine. The reasons are as follows:
- diabetes mellitus;
- pancreatitis;
- alcohol intoxication;
- traumatic brain injury;
- hemorrhages;
- operations on the membranes of the brain;
- strong excitation of the nervous system;
- multiple muscle injuries;
- severe infectious diseases;
- glycogen disorders in the body;
- thyrotoxicosis;
- excessive exercise;
- dysentery;
- frostbite;
- feverish conditions;
- intoxication;
- malnutrition (multi-dayhunger strike).
Ketones in the urine of a child
In children under the age of 13, but more often up to 10 years, ketones can be excreted in the urine in large quantities. If this is not associated with diabetes, the cause is a violation of the acid-base balance. Symptoms:
- strong smell of acetone from the mouth;
- nausea;
- weakness, sometimes to the point of fainting;
- headache (occurs abruptly);
- profuse vomiting;
- general weakness;
- sometimes there are pains in the stomach.
During attacks it is recommended to give "Stimol", "Citrargenin", sweet drink (tea, juice, water with syrup). The nutrition of such children should be strictly dietary, excluding fatty foods, muffins, especially with chocolate additives, sour fruits and vegetables, carbonated drinks. When the attack passes, the baby's condition becomes more or less stable. Unhe althy diet, fasting, nervous stress in babies, and some infectious diseases can cause children's non-diabetic ketonuria.
Ketonuria in pregnancy
Ketones in the urine during pregnancy can be harbingers of early toxicosis, as well as a specific disease called gestational diabetes, which occurs only in pregnant women. It occurs when there is a violation of carbohydrate metabolism in the body of the expectant mother and is very often found only in laboratory tests. The woman herself may not feel any pathological changes. However, this disease is mostlycases passing after childbirth can be a harbinger of ordinary diabetes mellitus, as well as endocrine pathologies. If the analysis showed ketones in the urine, the pregnant woman should undergo additional examinations to rule out the presence of true diabetes and thyroid disease. It is also very important to establish a proper balanced diet, sparing daily routine, completely eliminate the use of alcoholic beverages, toxic and harmful substances.
Ketonuria in diabetes mellitus
In insulin-dependent people, ketones in the urine are present daily in amounts up to 50 g. This state should be changed towards a significant decrease very quickly, no more than 2 days. This is achieved by adjusting insulin doses. Urine for research should be taken every 4 hours. Especially dangerous is the manifestation of ketonuria in diabetic babies. For about 10% of them, it ends in death. Most often, ketonuria is observed in patients with type I diabetes, that is, insulin-dependent. In all other diabetics, the increase in ketones occurs for the following reasons:
- insufficient doses of insulin;
- missed injections or low-quality insulin (expired);
- infectious and colds (sinusitis, pneumonia, meningitis and others);
- thyroid problems and related disorders;
- heart attack, stroke;
- injuries, surgeries;
- stress;
- taking hormonal contraceptives.
Ketones, diabetes and pregnancy
An indispensable indicator of the presence of diabetes is the detection along with ketones in the urine of glucose. If these two substances are found in the first trimester, there is a high probability that the woman has true diabetes that existed before pregnancy. This condition is very unfavorable for both the expectant mother and the developing fetus. It threatens a woman with polyhydramnios, complicated childbirth, vascular diseases, hypoglycemia, fetal fading, abortion, early and late preeclampsia, severe toxicosis. A child can be born with various anomalies. Inheritance of the disease is observed in 1.3% of children if the mother is insulin-dependent, and in 6.1% if the father is sick. If ketones are found in the urine during pregnancy, and the diagnosis of ordinary diabetes mellitus is confirmed, the expectant mother must necessarily undergo the therapy prescribed by the doctor and go on a strict diet.
Diagnostic Methods
Determination of ketones in urine can be carried out in the laboratory and at home. Legal's test is public. To perform it, a special strip impregnated with an alkaline substance and sodium nitroprusside is placed in the urine for 1 minute. The properties of impregnating solutions are such that if there is an increased proportion of ketones in the urine, they change color from white to brown-red. The brighter the color, the more ketones it contains. Their number this test shows only approximately. For more accurate numbers, a blood test is taken. But there is a huge advantage in the Legal test - itYou can do it yourself countless times. Assign it to diabetics, pregnant women, children with acetonemic syndrome. When treated with drugs of the sulfhydryl group (Captopril, Kapoten and others), the test does not justify itself and may give a false result.
Treatment and prevention
Ketosis can be treated at home. The main event for the patient is a strict diet. Of the drugs prescribed means "Cocarboxylase", "Essentiale", "Splenin", "Methionine". To prevent an increase in ketones in the urine, the following foods are prohibited:
- soup or borsch on bone, fish, mushroom broth;
-offal;
- smoked meats;
- pickles, marinades;
- river fish (except pike and zander);
- crayfish;
- fatty foods, including cottage cheese and cheese;
- sour apples, citrus fruits, cherries;
- some vegetables (tomatoes, peppers, eggplant, sorrel, spinach, rhubarb);
- mushrooms;
- sauces (mayonnaise, ketchup, adjika);
- cream cakes, chocolate, muffin;
- coffee, carbonated drinks, black tea.
Foods to be restricted:
- canned meat;
- seafood;
- herring;
- legumes;
- pasta;
- cupcakes, biscuits;
- some fruits (bananas, kiwi);
- sour cream.
In progressive ketosis and ketoacidosis, treatment is carried out in a hospital. Prevention of these conditions consists in proper nutrition and gentle mode.day, and for diabetic patients - in the timeliness of insulin injections and regular monitoring of ketones in the urine.
