USE OF CAPILLARY ?-HYDROXYBUTYRATE FOR THE DIAGNOSIS OF DIABETIC KETOACIDOSIS AT EMERGENCY ROOM: OUR ONE-YEAR EXPERIENCE

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USE OF CAPILLARY ?-HYDROXYBUTYRATE FOR THE DIAGNOSIS OF DIABETIC KETOACIDOSIS AT EMERGENCY ROOM: OUR ONE-YEAR EXPERIENCE
September 15, 2008
Erduan Sefedini, Manja Praˆek, Èeljko Metelko, Branko Novak, Zita Pinter
Vuk Vrhovac University Clinic, Zagreb, Croatia

Key words: diabetic ketoacidosis, ketone body,
?-hydroxybutyrate
SUMMARY
Diabetic ketoacidosis (DKA) is a life threatening
acute complication of diabetes characterized by
metabolic derangements caused by an imbalance of
glucoregulatory hormones. Ketone bodies (the
terminology is traditional, not scientific) as one of the
main manifestations are usually tested in urine where
their occurrence does not reflect their actual blood
levels. Quantitative measurement of the blood ketone
bodies (β-hydroxybutyrate) in capillary blood is now
available. We conducted a retrospective study by
reviewing laboratory data of patients treated at
Emergency Room. The primary objective of this study
was to assess the relationship between urine ketones
and blood ketones. The study included 122 patients.
Six patients met the criteria for DKA, whereas the
others had either diabetic ketosis or were free from
hyperglycemic complications. The main finding of the
study was elevation of blood ketones beyond 3.5
mmol/L, which correlated much better with diabetic
ketoacidosis than +++ urine ketones. Good
correlation between urine ketones and blood ketones
was observed at a low concentration of urine ketone
bodies.

Complete article is available online.