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When should determination of ketonemia be recommended?
Diabetes Technol Ther. 2002; 4(5):645-50.DT

Abstract

Diabetic ketoacidosis is a serious complication of type diabetes. beta-Hydroxybutyrate (beta-OHB) accounts for about 75% of ketones, and blood concentration can be determined with a sensor. The aim of this study was to investigate the frequency and degree of ketonemia in daily life of children with diabetes and to make a base for recommendations for determination of ketonemia in clinical practice. During 3 months 45 patients with type 1 diabetes since 1-10 years old (mean 4.4 +/- 3.3 years old) at the pediatric clinic in Linköping, Sweden, performed 24-h profiles (eight determinations) in 2 weeks with blood glucose and beta-OHB. The children performed 11,189 blood glucose and 7,057 beta-OHB measurements. Only 0.3% (n = 21) of beta-OHB measurements were > or = 1.0 mmol/L. An beta-OHB concentration > 0.2 mmol/L was more common in the morning than during the rest of the day (p < 0.001). Young children (4-7 years old) had values > or = 0.2 mmol/L more often than adolescents (p < 0.001). Blood glucose values > 15 mmol/L were more often accompanied by beta-OHB > 0.2 mmol/L (p < 0.001). High beta-OHB concentrations are rare in diabetic children with reasonably good metabolic control. Already a value > 0.4 mmol/L seems abnormal, and we recommend that patients retest glucose and ketones with beta-OHB > 0.4 mmol/L. Furthermore, we recommend that diabetic children and adolescents measure beta-OHB when symptoms like nausea or vomiting occur to differentiate ketoacidosis from gastroenteritis, and during infections, during periods with high blood glucose (> 15 mmol/L), and if they notice ketonuria. Monitoring beta-OHB should be routine for patients on pump therapy.

Authors+Show Affiliations

Division of Pediatrics, Department of Health and Environment, Linköping University, Linköping, Sweden. ulf.samuelsson@lio.seNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

12450447

Citation

Samuelsson, Ulf, and Johnny Ludvigsson. "When Should Determination of Ketonemia Be Recommended?" Diabetes Technology & Therapeutics, vol. 4, no. 5, 2002, pp. 645-50.
Samuelsson U, Ludvigsson J. When should determination of ketonemia be recommended? Diabetes Technol Ther. 2002;4(5):645-50.
Samuelsson, U., & Ludvigsson, J. (2002). When should determination of ketonemia be recommended? Diabetes Technology & Therapeutics, 4(5), 645-50.
Samuelsson U, Ludvigsson J. When Should Determination of Ketonemia Be Recommended. Diabetes Technol Ther. 2002;4(5):645-50. PubMed PMID: 12450447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - When should determination of ketonemia be recommended? AU - Samuelsson,Ulf, AU - Ludvigsson,Johnny, PY - 2002/11/27/pubmed PY - 2003/4/18/medline PY - 2002/11/27/entrez SP - 645 EP - 50 JF - Diabetes technology & therapeutics JO - Diabetes Technol Ther VL - 4 IS - 5 N2 - Diabetic ketoacidosis is a serious complication of type diabetes. beta-Hydroxybutyrate (beta-OHB) accounts for about 75% of ketones, and blood concentration can be determined with a sensor. The aim of this study was to investigate the frequency and degree of ketonemia in daily life of children with diabetes and to make a base for recommendations for determination of ketonemia in clinical practice. During 3 months 45 patients with type 1 diabetes since 1-10 years old (mean 4.4 +/- 3.3 years old) at the pediatric clinic in Linköping, Sweden, performed 24-h profiles (eight determinations) in 2 weeks with blood glucose and beta-OHB. The children performed 11,189 blood glucose and 7,057 beta-OHB measurements. Only 0.3% (n = 21) of beta-OHB measurements were > or = 1.0 mmol/L. An beta-OHB concentration > 0.2 mmol/L was more common in the morning than during the rest of the day (p < 0.001). Young children (4-7 years old) had values > or = 0.2 mmol/L more often than adolescents (p < 0.001). Blood glucose values > 15 mmol/L were more often accompanied by beta-OHB > 0.2 mmol/L (p < 0.001). High beta-OHB concentrations are rare in diabetic children with reasonably good metabolic control. Already a value > 0.4 mmol/L seems abnormal, and we recommend that patients retest glucose and ketones with beta-OHB > 0.4 mmol/L. Furthermore, we recommend that diabetic children and adolescents measure beta-OHB when symptoms like nausea or vomiting occur to differentiate ketoacidosis from gastroenteritis, and during infections, during periods with high blood glucose (> 15 mmol/L), and if they notice ketonuria. Monitoring beta-OHB should be routine for patients on pump therapy. SN - 1520-9156 UR - https://www.unboundmedicine.com/medline/citation/12450447/When_should_determination_of_ketonemia_be_recommended L2 - https://www.liebertpub.com/doi/10.1089/152091502320798286?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -