Question from New York, USA:

I am 38 weeks pregnant and have gestational diabetes which I am controlling with diet. I occasionally have high readings, but I am pretty much under control. The problem is ketones. They ranged from trace to moderate, a few times a week, not every week. I have read some of the answers to ketones questions on this board, and they said urine ketones are not harmful as long as they are not serum ketones. As a first time mother-to-be, I’m really worried, and have many questions:

What is the difference between urine and serum ketones?
How do I tell which type I’m having?
When I detect ketones in my urine, does that mean I already have ketones in my blood stream and they spill over in the urine?
If my body has to burn fat for energy, does that fat energy goes to the fetus as well at the same time?
I have read that burning fat for energy doesn’t work well with the brain cells. Therefore, burning ketones in the mother is harmful for the fetus’ brain development. Is that true?
How harmful are ketones to the fetus?
I can always tell I’m burning ketones because my baby reacts a lot by moving vigorously. Do you think harm is being done? I know I should be eating and drinking when I notice the sign but sometimes I’m sleeping and couldn’t really get up to eat and drink.
Do people without diabetes, pregnant or not, burn ketones also?