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When should determination of ketonemia be recommended?
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
2002 (English)In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 4, no 5, 645-650 p.Article in journal (Refereed) Published
Abstract [en]

Diabetic ketoacidosis is a serious complication of type diabetes. β-Hydroxybutyrate (β-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 β-OHB. The children performed 11,189 blood glucose and 7,057 β-OHB measurements. Only 0.3% (n = 21) of β-OHB measurements were ≥ 1.0 mmol/L. An β-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 ≥ 0.2 mmol/L more often than adolescents (p < 0.001). Blood glucose values > 15 mmol/L were more often accompanied by β-OHB > 0.2 mmol/L (p < 0.001). High β-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 β-OHB > 0.4 mmol/L. Furthermore, we recommend that diabetic children and adolescents measure β-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 β-OHB should be routine for patients on pump therapy.

Place, publisher, year, edition, pages
2002. Vol. 4, no 5, 645-650 p.
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Medical and Health Sciences
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URN: urn:nbn:se:liu:diva-26524DOI: 10.1089/152091502320798286Local ID: 11084OAI: oai:DiVA.org:liu-26524DiVA: diva2:247073
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13

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Samuelsson, UlfLudvigsson, Johnny

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