Sick day management using blood 3‐hydroxybutyrate (3‐OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trial

Abstract

Blood ketone monitoring during sick days appears acceptable to and preferred by young people with Type 1 diabetes. Routine implementation of blood 3-OHB monitoring for the management of sick days and impending DKA can potentially reduce hospitalization/emergency assessment compared with urine ketone testing and offers potential cost savings.

Diabetic Ketoacidosis in Infants, Children, and Adolescents

“…The most common cause of DKA in insulin pump users is failure to take extra insulin with a pen or syringe when hyperglycemia and hyperketonemia or ketonuria occur. Home measurement of blood ␤-OHB, when compared with urine ketone testing, decreases diabetes-related hospital visits (both emergency department visits and hospitalizations) by the early identification and treatment of ketosis (111). Blood ␤-OHB measurements may be especially valuable to prevent DKA in patients who use a pump because interrupted insulin delivery rapidly leads to ketosis.…”

Blood Ketones: Measurement, Interpretation, Limitations, and Utility in the Management of Diabetic Ketoacidosis

“…Previous work has shown that urine ketone strips can be used as a means of admission avoidance in an adult population when combined with advice by telephone [67]. Other authors have looked at the use of capillary ketone meters in a pediatric population and found that overall emergency room visits and admissions were significantly reduced (not just for DKA) [68]. These data suggest that the use of ketone meters in the prevention of DKA and subsequent hospitalization make the technology cost-effective.…”

Cetoacidose diabética em adultos: atualização de uma complicação antiga

“…Estudos mais recentes têm sugerido que a dosagem capilar de BHB possa também ser extremamente útil para o diagnóstico domiciliar de CAD incipiente, facilitando a recuperação precoce. É recomendada a medida domiciliar de cetonemia no sangue capilar ou cetonúria com fita reagente própria para pacientes com DM1 com hiperglicemia persistente acentuada (≥ 300 mg/dL ou até menos, a critério clíni-co), especialmente na vigência de stress ou quadros infecciosos (40)(41)(42)(43)(44).…”