title: Evaluation of the Accuracy of Capillary Hydroxybutyrate Measurement Compared with Other Measurements in the Diagnosis of Diabetic Ketoacidosis: A Systematic Review.
abstract: A complication of diabetes is diabetic ketoacidosis (DKA), which if left untreated is a life threatening condition. Prompt and accurate diagnosis of DKA is required for the commencement of life saving interventions. Measurements of ketone bodies in DKA have usually been through nitroprusside urine acetoacetate testing. The aim of this systematic review was to examine whether capillary β-hydroxybutyrate (β-OHB) testing is more accurate compared to other diagnostic methods of DKA. The following electronic databases were searched: EBSCO Host, MEDLINE, PSYCHInfo, CINAHL and Science Direct for publications from 1 January 2005 and up to and including 1 January 2016. Inclusion criteria were: Adults 18 years and over and known type 1 or type 2 diabetes. Retrospective and prospective observation studies were included. A total of nine studies met the inclusion criteria. Capillary β-OHB was found to have high sensitivity, specificity, positive predictive value and negative predictive value in identifying DKA compared to urinary ketone testing.
authors: College of Nursing, Midwifery and Healthcare, University of West London, Boston Manor Road Brentford, Middlesex TW8 9GA, UK. joanne.brooke@uwl.ac.uk.
authors: Joanne
authors: J
authors: Brooke
authors: Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London SE9 2UG, UK. m.stiell@greenwich.ac.uk.
authors: Marlon
authors: M
authors: Stiell
authors: Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London SE9 2UG, UK. o.ojo@greenwich.ac.uk.
authors: Omorogieva
authors: O
authors: Ojo
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood*; D000090:Acetoacetates / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000090:Acetoacetates; D011933:Reagent Kits, Diagnostic; C016635:acetoacetic acid; D020155:3-Hydroxybutyric Acid
keywords: diabetes ketoacidosis; emergency department; ketones; point of care testing; type 1 diabetes; type 2 diabetes