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Understanding Your Laboratory Test: What Patients Should Know

Published: August 9, 2026Updated: August 10, 2026

This test measures the level of acetoacetate, a ketone body, in your blood to help diagnose and monitor conditions like diabetic ketoacidosis.

Quick summary

{"Acetoacetate is a ketone body produced when the body breaks down fat for energy","High levels indicate diabetic ketoacidosis (DKA), a serious complication of diabetes","The test helps doctors diagnose and monitor treatment of DKA","Blood is drawn from a vein in your arm for this test","Results are typically available within the same day"}

Medically reviewed by WellAlly Editorial TeamLast reviewed August 10, 2026Editorial policy

Key facts at a glance

LOINC
35867-1
Short code
AcAc
Synonyms
Acetoacet SerPl-sCnc
Category
chemistry
Sample
serum
Container
Serum separator tube (SST) or plain red top tube
Units
N/A
Ref low
20
Ref high
120
Critical range
— – 3000 N/A
Fasting
false
Population
adult
Sex
all
Age range
18–100 years
Method
Enzymatic method using beta-hydroxybutyrate dehydrogenase or colorimetric assay
CPT
82010
SNOMED
314200006
Specimen volume
1.0 mL serum minimum
Stability
Room temperature: 24 hours; Refrigerated (2-8°C): 7 days; Frozen (-20°C): 30 days
Hemolysis max
50
Lipemia max
300
Icterus max
20
TAT
2–24 hours
Order
routine

What is this test? This test is a laboratory procedure that measures specific substances in a sample of your blood, urine, or other body tissue so your healthcare provider can learn more about how your body is working and detect possible health problems.

The acetoacetate test measures the amount of acetoacetate in your blood serum or plasma. Acetoacetate is one of three ketone bodies (along with beta-hydroxybutyrate and acetone) that your liver produces when your body needs to break down fat for energy instead of glucose.

Why do I need this test? Your doctor may order this test to check for a medical condition, confirm or rule out a diagnosis, monitor an ongoing illness, or see how well a treatment is working. It is also often included as part of a routine checkup to keep track of your overall health.

Your doctor may order this test if you have symptoms of diabetic ketoacidosis (DKA), such as excessive thirst, frequent urination, nausea, abdominal pain, confusion, or fruity-smelling breath. It is also used to monitor how well treatment is working if you have been diagnosed with DKA.

How is the test performed? A trained healthcare professional will collect a small sample, usually by drawing blood from a vein in your arm with a thin needle, though some tests use a urine or swab sample instead. The sample is then sent to a laboratory for analysis, and the procedure typically takes only a few minutes with little discomfort.

A healthcare professional will draw a small blood sample from a vein in your arm using a needle. The blood will be collected in a tube and sent to a laboratory for analysis. You do not need to fast before this test unless your doctor instructs you to.

What do the results mean? Your results are compared with established reference ranges. Values within the normal range usually suggest typical body function, while values that are higher or lower than expected may point to a condition that needs further evaluation. Your healthcare provider will explain what your specific results mean and discuss any next steps with you.

Elevated levels of acetoacetate typically indicate diabetic ketoacidosis, a potentially life-threatening condition that occurs when your body produces too many ketones due to insufficient insulin. Your doctor will interpret your results along with other clinical findings to determine the appropriate treatment.

Reference range

Reference range: 20-120 μmol/L (varies by laboratory methodology)N/A

Specimen: serum

No specific fasting required. Avoid prolonged fasting (>12 hours) before sample collection as this may elevate results. Inform healthcare provider of any ketogenic diet or fasting status.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

Elevated acetoacetate levels are primarily associated with diabetic ketoacidosis (DKA), a serious complication of type 1 and type 2 diabetes. DKA occurs when there is a severe shortage of insulin, causing the body to break down fat instead of glucose for energy, producing excess ketone bodies. Other conditions that may cause elevated ketone levels include prolonged fasting, very low-carbohydrate diets, alcoholism, and certain metabolic disorders. This test helps healthcare providers diagnose DKA, assess its severity, and monitor the effectiveness of treatment.

Frequently asked questions

Is fasting required before the test?
Fasting is not typically required for the acetoacetate test. However, follow any specific instructions your doctor provides, as they may have reasons to request fasting based on your individual situation.
Are there any risks associated with this test?
The risks are minimal and similar to any standard blood draw, including slight bruising, bleeding, or infection at the puncture site. Some people may feel lightheaded during or after the blood draw.
How long does it take to get results?
Results are usually available within the same day or within a few days, depending on the laboratory. Your healthcare provider will contact you with the results.
What happens if my acetoacetate levels are high?
High levels indicate that you may have diabetic ketoacidosis, which requires immediate medical treatment. Treatment typically involves insulin therapy, fluid replacement, and electrolyte management in a hospital setting. Contact your healthcare provider immediately if you have symptoms of DKA.
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 10, 2026. · Read our editorial policy