Evaluation of-capillary 8-hydroxybutyrate measurement In diabetic ketoacidosis

Abstract EN

Background : current criteria for the diagnosis of diabetic ketoacidosis (DKA) are limited by their no specificity (serum bicarbonate [HC03] and pH) and qualitative nature (the presence of ketonemia / ketonuria).

A new method is now available to measure capillary levels of fs-hydroxybutyrate (Is-0HB), It is a quantitative and enzymatic test that uses the same equipment as for home capillary blood glucose determination but with specific strips.

Aims : the aim of this study was to evaluate the use of measurement of capillary B-hydroxybutyrate (P-OHB) during the diagnosis and follow up of type 1 diabetic patients with DKA Methods : this study was conducted on 40 type 1 diabetic patients presented to (NIDE) with DKA and who were aged 4-20 years and half of them was males.

140 capillary blood samples were tested for P-hydroxybutyrate using blood P-OHB test strips.

Measurement of serum bicarbonate (HC03), blood glucose and urine acetone and estimation of venous blood pH and anion gap had been done for all patients.

Results : linear regression revealed highly significant correlation between capillary P-OHB levels and all indices of acidosis but no significant correlation between acetone in urine and serum bicarbonate.

Using regression to predict values of HCO3, pH and anion gap from P-OHB levels revealed that levels of P-OHB of 1.4, 2.7, 3.5, 1.9 and 4.0 mmol / l corresponded to HC03 levels of >18, 15-18-, 10-<15, 5 mEq / l.>10 Conclusion : the measurement of capillary P-OHB levels is easy and gives rapid and objective results.

Capillary P-OHB levels are more predictable than urinary acetone for degrees of acids' resend severity of DKA and can" be used to diagnose and follow up of type! diabetic patients with DKA to improve their management.