Related Experiment Video
Updated: Aug 28, 2025

Measurement of Differentially Methylated INS DNA Species in Human Serum Samples as a Biomarker of Islet β Cell Death
Published on: December 21, 2016
Serum ketone body measurement in patients with diabetic ketoacidosis
Tomonao Hirobata1, Hidefumi Inaba1,2, Yosuke Kaido1
1Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, Wakayama 640-8558 Japan.
Background:
Diabetic ketoacidosis (DKA) is a critical manifestation in patients with diabetes mellitus. DKA has been conventionally diagnosed by the presence of hyperglycemia (blood glucose levels > 250 mg/dl) and metabolic acidosis (blood gas bicarbonate [HCO3 -] < 18 mmol/l and pH in blood gas < 7.30). However, quantitative evaluation of serum ketone bodies has not been established. The current study investigates serum ketone body levels in patients suspected for DKA.
Methods:
We have retrospectively evaluated patients with hyperglycemia whose serum ketone body levels at the outpatient clinic and emergency department were measured simultaneously with blood gas analysis during 2011-2019. Clinical backgrounds, severity of diabetes, serum ketone bodies, and blood gas factors were analyzed.
Results:
Seventy-two patients were enrolled in the study, after the exclusion of patients who had ketosis due to factors other than diabetes. Serum ketone body levels were negatively correlated with the levels of blood HCO3 - and pH. By receiver-operating-characteristic curve analyses, optimal cut-off values for diagnosis of DKA were determined at 6.3 mmol/l of beta-hydroxybutyrate, 1.4 mmol/l of acetoacetate, and 8.0 mmol/l of total ketone body, respectively. Moreover, serum ketone bodies appeared to effectively differentiate between type 1 and type 2 diabetes mellitus. The cut-off values were higher than those in previous reports.
Conclusions:
Serum ketone body levels were thought to be useful in the diagnosis of DKA. Further investigations with increased numbers of patients are required to establish the appropriate application of serum ketone bodies in patients with DKA.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s13340-022-00581-2.
More Related Videos
07:22Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
Published on: March 7, 2025
04:36Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
Published on: October 2, 2020
Related Concept Videos
Diabetes: Symptoms, Diagnosis, and Complications
Serum Studies: Renal Function Tests
Diagnosing Acidosis and Alkalosis
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
Hypoglycemia and Glucagon
Metabolic States of the Body: Fasting and Starvation
Diabetes Mellitus: Type 2 and Gestational