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Unless you have diabetes, then ketones in the urine generally means you hadn't eaten in a while prior to the test (over 12 hours) and/or you had only eaten protein/fat or were in a state of relative starvation (eating little over the past few days or more).

The doctor didn't mention it because unless you have diabetes then it's a rather insignificant finding. People on the Atkin's diet actually aim to get ketones in their urine by eating only protein and fat... it is a sign the body is burning fat for fuel.

So it's not a whole lot to worry about...
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