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Can a person with ketones in urine exercise?

Prof Dinesh Dhanwal
Prof of Medicine and Head of Endocrinology,
Maulana Azad Medical College,
New Delhi

Q: I am 35 years old man suffering from diabetes (high and uncontrollable). My current readings are 165 mg/dL (Fasting) and 250 mg/dL (PP). There are also traces of ketones in my urine samples. For the past one week, I am on insulin - mixtard (12-0-6) and diapride forte (1-0-1). I have read somewhere that a person with ketones in urine should avoid exercising. But it has been advised to us that we should do regular exercises to remain fit. Please suggest some muscle strengthening exercises.

A:Positive ketones in urine suggest absolute deficiency of endogenous (from your body itself) at that point of time and one should take insulin as treatment. This may indirectly suggest type of diabetes as positive ketones suggests diagnosis of type I diabetes. All type 1 DM need insulin for treatment. The confirmative test for type 1 DM is antibody test in blood. When insulin is given ketones disappear quickly in a few hours only. Advice not to exercise is given for that short time only.Coming to your case, urine ketones as trace have no meaning. Your blood glucose levels are not too high to take insulin and medication (diapride). By now your blood glucose must have come down and in my opinion you can have a good control with oral medications only. If you have no heart problem (clearance from a physician) then you can go ahead with muscle strengthening exercise. For diabetes control 30 metres daily brisk walk/jogging is good enough.