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Near patient blood ketone measurements and their utility in predicting diabetic ketoacidosis.
Diabet Med 2005; 22(2):221-4DM

Abstract

AIM

To assess the utility of near patient blood ketone measurements in predicting diabetic ketoacidosis (DKA) among a group of hyperglycaemic unwell patients presenting to a hospital emergency department.

METHODS

Near patient blood beta-hydroxybutyrate (beta-OHB) testing has recently been introduced as a new tool in our hospital Accident and Emergency department (A&E) for patients with a finger-prick glucose of > 11 mmol/l. We reviewed the records of the first 50 patients to have a beta-OHB measurement to establish if they developed DKA or received treatment with intravenous insulin within 48 h of presentation. We then compared the diagnostic power of beta-OHB measurements with other clinical, physiological and biochemical markers of DKA.

RESULTS

Nine patients had DKA, eight had a compensated metabolic acidosis secondary to raised serum ketones, and 33 had no evidence of DKA during the following 48 h. The median (range) beta-OHB levels in each group were 6.0 (3.1-6.0) mmol/l, 3.4 (1.2-5.7) mmol/l, and 0.1 (0.0-1.2) mmol/l, respectively. A beta-OHB level of > or = 3.0 mmol/l had a sensitivity of 100% and specificity of 88% for DKA. All those with beta-OHB level > 3.0 mmol/l required treatment with intravenous insulin.

CONCLUSION

Measuring beta-OHB when a hyperglycaemic patient is identified could offer a simple method of identifying at an early stage those patients at highest risk of DKA (beta-OHB > 3.0 mmol/l), and redirecting the search for a diagnosis in others (beta-OHB < 1.0 mmol/l).

Authors+Show Affiliations

Diabeticare, The Hillingdon Hospital, Uxbridge, UK. steve.harris@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

15660743

Citation

Harris, S, et al. "Near Patient Blood Ketone Measurements and Their Utility in Predicting Diabetic Ketoacidosis." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 22, no. 2, 2005, pp. 221-4.
Harris S, Ng R, Syed H, et al. Near patient blood ketone measurements and their utility in predicting diabetic ketoacidosis. Diabet Med. 2005;22(2):221-4.
Harris, S., Ng, R., Syed, H., & Hillson, R. (2005). Near patient blood ketone measurements and their utility in predicting diabetic ketoacidosis. Diabetic Medicine : a Journal of the British Diabetic Association, 22(2), pp. 221-4.
Harris S, et al. Near Patient Blood Ketone Measurements and Their Utility in Predicting Diabetic Ketoacidosis. Diabet Med. 2005;22(2):221-4. PubMed PMID: 15660743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Near patient blood ketone measurements and their utility in predicting diabetic ketoacidosis. AU - Harris,S, AU - Ng,R, AU - Syed,H, AU - Hillson,R, PY - 2005/1/22/pubmed PY - 2005/4/20/medline PY - 2005/1/22/entrez SP - 221 EP - 4 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 22 IS - 2 N2 - AIM: To assess the utility of near patient blood ketone measurements in predicting diabetic ketoacidosis (DKA) among a group of hyperglycaemic unwell patients presenting to a hospital emergency department. METHODS: Near patient blood beta-hydroxybutyrate (beta-OHB) testing has recently been introduced as a new tool in our hospital Accident and Emergency department (A&E) for patients with a finger-prick glucose of > 11 mmol/l. We reviewed the records of the first 50 patients to have a beta-OHB measurement to establish if they developed DKA or received treatment with intravenous insulin within 48 h of presentation. We then compared the diagnostic power of beta-OHB measurements with other clinical, physiological and biochemical markers of DKA. RESULTS: Nine patients had DKA, eight had a compensated metabolic acidosis secondary to raised serum ketones, and 33 had no evidence of DKA during the following 48 h. The median (range) beta-OHB levels in each group were 6.0 (3.1-6.0) mmol/l, 3.4 (1.2-5.7) mmol/l, and 0.1 (0.0-1.2) mmol/l, respectively. A beta-OHB level of > or = 3.0 mmol/l had a sensitivity of 100% and specificity of 88% for DKA. All those with beta-OHB level > 3.0 mmol/l required treatment with intravenous insulin. CONCLUSION: Measuring beta-OHB when a hyperglycaemic patient is identified could offer a simple method of identifying at an early stage those patients at highest risk of DKA (beta-OHB > 3.0 mmol/l), and redirecting the search for a diagnosis in others (beta-OHB < 1.0 mmol/l). SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/15660743/Near_patient_blood_ketone_measurements_and_their_utility_in_predicting_diabetic_ketoacidosis_ L2 - https://doi.org/10.1111/j.1464-5491.2004.01374.x DB - PRIME DP - Unbound Medicine ER -