A urine sample that tests positive for ketones and negative for glucose is most likely from a patient suffering from:

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The presence of ketones in the urine indicates that the body is in a state of ketosis, which occurs when there is a lack of glucose available for energy and the body begins to break down stored fat instead. This often occurs in situations of prolonged fasting or starvation. The absence of glucose in the urine suggests that the patient is not producing enough insulin or is not using it effectively, which may be a factor in starvation or prolonged fasting. Diabetes insipidus and polydipsia would not cause the presence of ketones in the urine. Diabetes mellitus would likely result in both ketones and glucose being present in the urine.

A Urine Sample That Tests Positive for Ketones and Negative