title: Blood Ketones: Measurement, Interpretation, Limitations, and Utility in the Management of Diabetic Ketoacidosis.
abstract: Diabetic ketoacidosis (DKA) remains a common medical emergency. Over the last few years, new national guidelines have changed the focus in managing the condition from being glucose-centered to ketone-centered. With the advent of advancing technology and the increasing use of hand-held, point-of-care ketone meters, greater emphasis is placed on making treatment decisions based on these readings. Furthermore, recent warnings about euglycemic DKA occurring in people with diabetes using sodium-glucose co-transporter 2 (SGLT-2) inhibitors urge clinicians to inform their patients of this condition and possible testing options. This review describes the reasons for a change in treating DKA, and outlines the benefits and limitations of using ketone readings, in particular highlighting the difference between urine and capillary readings.
authors.affiliation: Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk NR4 7UY, UK.
authors.forename: Ketan
authors.initials: K
authors.lastname: Dhatariya
mesh_terms: D003131:Combined Modality Therapy / Q000191:economics; D015986:Confounding Factors, Epidemiologic; D016883:Diabetic Ketoacidosis / Q000191:economics / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy*; D004632:Emergency Medical Services / Q000191:economics / Q000639:trends; D017048:Health Care Costs; D006801:Humans; D007657:Ketone Bodies / Q000097:blood* / Q000652:urine; D007659:Ketones / Q000097:blood* / Q000652:urine; D000067716:Point-of-Care Testing / Q000191:economics; D015995:Prevalence; D055502:Secondary Prevention / Q000191:economics; D012720:Severity of Illness Index
chemical_list: D007657:Ketone Bodies; D007659:Ketones